The Senate has opened a probe into the loss of Sh176.1 billion allocated in the last nine years to medical schemes for teachers, police and prison officers.

At the centre of the probe is the Medical Administrators Kenya Limited (MAKL), a private company founded on the grounds of curbing medical billing fraud cases.

The probe by the Senate is informed by frustrations teachers face including lack of access to medical services forcing them to dig deeper into their pockets to meet treatment expenses.

Policy holders

Without option, this situation has forced policy holders to seek alternative service in another place despite the government having paid for their medical insurance cover.

This has triggered the Senate to commence investigations in what Senator Raphael Chimera (Nominated) terms as impunity and a sense of graft entitlement by some unscrupulous business people.

“The Teachers Service Commission and the National Police Service Commission need to come before this House to explain the delays in processing of the medical insurance claims and payment to hospitals sub-contracted to MAKL,” said Chimera (pictured).

He particularly wants the Health Committee of the Senate to be provided with details of the medical insurance schemes for the teachers and police officers sub-contracted and managed by MAKL “indicating the number of respective beneficiaries and panels of medical and healthcare service providers.”

In response to this request, the Senate Clerk Jeremiah Nyegenye, has separately written to the TSC and NPSC seeking to find out how the medical insurance claims for teachers and police are processed respectively.

“The committee should therefore report on the criteria for processing claims at MAKL, explaining the delays reported by the teachers and the police officers in the processing of medical insurance claims and treatment in the MAKL contracted hospitals,” the letter seen by the People Daily, reads in part.

MAKL and Bliss, are the capitation providers and administrators for the teachers, police and Kenya Prisons medical insurance-schemes. Bliss is believed to have an association with Clinix, which at one time, was involved in ugly scandals at the NHIF, a few years ago.