EACC Goes After Senior Hospital Managers Who Swindled Ksh 171M From NHIF

A Photo Of EACC Headquarters, Integrity Centre Nairobi
A section of the EACC Headquarters Integrity Centre in Nairobi County

The Ethics and Anti-Corruption Commission (EACC) on Saturday reacted following revelations that select hospitals and well-connected individuals swindled Ksh171 million from the National Hospital Insurance Fund (NHIF) through a series of fraudulent activities.

EACC remarked that it was investigating the matter adding that all those found culpable will be brought to book.

"This includes prosecution and/or forfeiture of any monies found to have been fraudulently acquired from public coffers," the commission indicated.

Health CS Susan Nakhumicha.
Health CS Susan Nakhumicha during a meeting with KMPDU officials at her office on Friday, December 30, 2022.
Ministry of Health

This comes after Health Cabinet Secretary Susan Nakhumicha on Friday suspended 27 hospitals accused of the fraud that culminated in NHIF losing millions worth of public funds.

Through an audit done on 67 hospitals between July 2022 and June 2023, it was established that 27 had defrauded the government.

Since then, the operations at the hospitals have been halted as the authorities commenced investigations into the matter on January 5.

According to Nakhumicha, the decision to suspend the hospitals followed an exposé by NTV which laid bare how NHIF had lost Ksh20 billion due to the fraudulent scheme.

"Extrapolating this to the total population of 8,886 hospitals, it is estimated that approximately 3,440 might have been engaged in fraudulent activities, potentially exceeding Sh20 billion in losses from about 40pc fraudulent hospitals,"

"The widespread nature of these alleged fraudulent cases is deeply concerning, the list of implicated facilities includes instances of induced demand, particularly targeting vulnerable citizens, notably older individuals," she stated following the suspension of the hospitals.

While making her statement, Nakhumicha clarified that the malpractices ranged from dormant NHIF accounts of patients being activated as a guise to bill fictitious treatments.

Other hospitals also created fictitious records and manufactured claims.

NHIF building in Nairobi.