Health Cabinet Secretary Susan Nakhumicha has ordered all hospitals that fraudulently acquired National Health Insurance (NHIF) funds through fake claims to refund the money totalling Ksh20 billion.
Nakhumicha issued the directive on Thursday, February 15, after an NHIF board committee meeting. She also ordered NHIF to stop processing payments of suspicious claims.
Meanwhile, the board is expected to make decisions on whether to suspend or terminate the healthcare providers caught in the fraud.
"The Board is to decide on the fate of the affected Health Care Providers in line with clause 16.6 of the contracts" CS Nakhumicha disclosed.
CS Nhakumicha and the board made the recommendations after she appeared before the Parliamentary Health Committee chaired by Dr Robert Pukose to address concerns about rampant corruption at NHIF.
Accompanied by the CEO, Elijah Wachira, Nakhumicha acknowledged the system which was edged out by the new Social Health Insurance Fund (SHIF), needed an extensive audit amid an internal investigation.
Wachira highlighted discrepancies at medical centres, that were highlighted to be at the centre of the NHIF fraud.
In response, legislators ordered the ministry to release the names of officers in one of the hospitals based in Eastleigh, Nairobi, said to be involved in fraudulent payments within one week.
The centre was accused of filing 1,706 claims with discrepancies leading to a loss of Ksh15 million.
In early January, CS Nakhumicha suspended 27 hospitals that were accused of causing NHIF to lose Ksh20 billion through fraudulent claims.
While suspending the hospitals, Nhakumicha clarified that the fraud scheme ranged from the activation of dormant NHIF accounts of patients to the ballooning of bills.
The Ethics and Anti-Corruption Commission (EACC) launched investigations into the exposé and promised to hold the culprits accountable.
