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Susan Wafula, the health cabinet secretary, has reaffirmed her commitment to doing everything in her power to bring rationality back to the industry.
The CS disclosed how small hospitals band together to scam the National Health Insurance Fund on Tuesday while speaking at a national high-level discussion on health financing.
According to the CS, medical claims from a few of the smaller hospitals located throughout the nation indicate that they appear to be carrying out more operations than the country's referral hospitals.
“As a country, people must be held accountable. We cannot have people raising resources for health and we have others misusing the resources,” she said.
“There is no way that some small facilities somewhere receive the highest claims in this country from NHIF; that this facility does more surgeries than KNH, KUTRRH, MTRH and some of the big FBO facilities we have around. It is not possible, it is theft and we shall call them out for that.”
The CS instructed Tim Theuri, CEO of the Kenya Healthcare Federation, to join the campaign and declare that she will pursue any private sector providers found to be participating in fraud.
In a statement released on Monday, Theuri endorsed the actions taken by the CS.
He said that they would not defend any provider proven to be at fault, saying that the measure would enforce accountability in the industry.
The CS suspended eight NHIF branch managers in areas where fraud suspicions have been made on Monday.
She also stated that a lifestyle audit will be required of every employee at the fund.
The CS stated that as part of the EACC exercise, the staff would be required to describe their financial resources, which would be expected to be consistent with their remuneration.
She said that any discrepancies that are highlighted will be the subject of additional inquiries and subject to legal action.
