Health Cabinet Secretary Susan Nakhumicha has taken decisive action against fraudulent activities within the National Health Insurance Fund (NHIF), suspending 27 hospitals accused of defrauding the government and causing a staggering loss of Ksh20 billion.
According to a statement from the Ministry of Health, a comprehensive audit of 67 hospitals between July 2022 and June 2023 uncovered widespread fraudulent activities, with approximately 3,440 out of 8,886 medical centers implicated in the scandal.
In a statement, the Ministry of Health highlighted the gravity of the situation, stating, “The list of implicated facilities includes instances of induced demand, particularly targeting vulnerable citizens, notably older individuals, residing in regions such as Nairobi, Meru, Nyahururu, and others.”
The suspended hospitals, including Jekim Hospital, Joy Nursing & Maternity, Beirut Pharmacy and Medical Centre, and several others, are facing suspensions ranging from three to six months as a consequence of their involvement in the fraudulent activities.
Health CS Nakhumicha also revealed disturbing details of the fraudulent activities, including induced sickness, activation of dormant NHIF accounts, and enticement of healthy students and security guards to provide biometrics for fraudulent purposes.
In response to these revelations, Nakhumicha emphasized the severity of the situation, stating, “Fictitious records, manufactured claims, and deceptive practices have all contributed to defrauding the Fund.”
The Ministry of Health has assured the public that efforts to recover the lost funds are underway, with Ksh17.7 million recovered so far. The suspension of the hospitals marks a crucial step in restoring integrity to the healthcare system and addressing the fraudulent activities within the NHIF scheme.