Healthcare fraud is criminal. It is an unfortunate act that disenfranchises millions of Kenyans including the elderly and vulnerable.
Unscrupulous hospitals induce demand for unnecessary medical procedures, fictitious medical procedures and engage in other billing fraud.
Through digitization, this theft will be a thing of the past, as the Cabinet Secretary to the Ministry of Health has stated.
The Social Health Insurance (SHI) Act 2023 replacing NHIF with the Social Health Authority (SHA) gives a special focus in combating fraud in our health facilities.
SHA introduces tech-driven solutions that will be pivotal in reducing fraud, emphasize automation and minimizing human interface whilst improving the patients’ outcomes through enabled end-to-end visibility of health processes.
The management of data through a centralized data system will facilitate easier access to health records, benefiting both healthcare providers and patients.
Hon. Nakhumicha, the Health CS, has revealed that her ministry has flagged 27 hospitals alleged to be at the center of up to Sh171m siphoned through NHIF via suspected false claims.
The licenses of those facilities have been suspended.
“We will recover funds lost through fraudulent billing, and we are putting the necessary measures to ensure such theft of public funds does not recur”, said Nakhumicha, in warning to the guilty parties.