The situation at the National Hospital Insurance Fund (NHIF) seems to be dire, with allegations of rampant fraud and mismanagement of funds. National Health and Insurance Fund (NHIF) acting CEO Samson Kuhora is on the spot over the alleged fraudulent claims;
90-day Inquiry: Legislators launched a 90-day inquiry into alleged corruption and fraud at NHIF after claims of medical fraud surfaced in Nairobi and Meru counties.
Edu Afya Scheme: One of the main concerns raised during the inquiry was the Edu Afya scheme, which caters to high school students. Claims under this scheme have surged to Ksh3.5 billion in the last financial year from Ksh.800 million four years ago. The significant increase in claims has raised suspicions of potential money embezzlement.
Forensic Audits: NHIF’s Acting CEO, Dr. Samson Kuhora, admitted to cases of fraud in the payment of claims. He stated that there have been several forensic audits conducted to identify the root problem.
Lack of Due Diligence: NHIF was questioned about how the claims were generated and paid without proper due diligence being conducted. This suggests a lack of oversight and control over the claims process.
Suspended Contracts: In response to the ongoing investigation, NHIF has taken action by suspending contracts with six hospitals for 90 days. These hospitals are suspected of being involved in fraudulent activities.
Collusion with Hospitals Abroad: There are allegations that some NHIF officials have colluded with hospitals outside the country, such as those in India, to orchestrate a scheme to steal from public funds.
The situation appears to be serious and requires a thorough investigation to identify the extent of the alleged corruption and fraudulent activities. The legislators’ inquiry aims to hold accountable those responsible for mismanagement and protect public funds from further misuse.
By Abigael Chemok