Health Cabinet Secretary Susan Nakhumicha has issued a warning that the operating licenses of eight private health facilities may be revoked if they are found responsible for the recent scandal involving the National Health Insurance Fund (NHIF).
In response to the allegations, the CS has also suspended eight NHIF branch managers who were employed at the implicated health facilities. The Ministry of Health, in collaboration with the Ethics and Anti-Corruption Commission (EACC), has launched an investigation to hold the responsible individuals accountable.
The NHIF officials are accused of engaging in fraudulent activities that resulted in the loss of approximately 1.6 billion Kenyan shillings, affecting both Kenyan citizens and the government.
The decision taken by Nakhumicha comes after public outrage following an exposé that revealed the dishonest practices of certain private health facilities. These facilities were reported to have embezzled significant amounts of money from vulnerable elderly patients in Meru, Embu, Kiambu, and Nairobi counties.
“I have had a meeting with the NHIF board chair this morning and instructed him to commence investigations immediately – including inviting the whistleblower to share details regarding this heartless and ruthless cartel,” Nakhumicha said
In addition, Nakhumicha called upon the NHIF Board to take appropriate action against the private hospitals implicated in the scandal. She condemned the collusion between cartels and branch managers, who conspired to deceive and steal from vulnerable individuals and government funds. Nakhumicha issued directives to various organizations, including the EACC, KMPDC, and PPB, instructing them to collaborate with the NHIF board in conducting investigations into the alleged fraud. She requested a preliminary report on the findings to be submitted to her by tomorrow (Wednesday).
“I have directed that a preliminary report be shared with me within 48 hours by the NHIF Board,” she said
The CS was accompanied by NHIF Board Chair, Eng Michael Kamau, and Mary Muthoni, Principal Secretary of Public Health and Professional Standards, along with other senior Ministry officials.
To ensure that suspected facilities involved in malpractice are halted from continuing their operations, Nakhumicha instructed the KMPDC and PPB to initiate immediate investigations, which should be concluded within 48 hours, focusing on the families mentioned in the recent television exposé.
Patients to be transferred
As a result, services in the affected facilities will be automatically affected as they were expected to begin transferring their patients to facilitate an inspection process, which may lead to closure.
“Starting now, within 24 hours, the facilities are directed to immediately transfer their inpatients and evacuate their process. This will allow KMPDC to commence their inspections. Thereafter, our teams will enforce the directive for closure should they inspect and find them culpable, and they will remain closed until investigations are concluded,” stated the CS, even as rural private hospitals distanced themselves from the eight facilities mentioned.
Dr. Brian Lishenga, the National Chairman of the Rural Private Hospitals Association of Kenya (RUPHA), affirmed in a statement that none of the eight hospitals implicated in the exposé are members of RUPHA.
Furthermore, the CS instructed the Division of Standards and Regulations to take action on the matter and provide a report.
“I have also made a special request to EACC to collaborate with NHIF and conduct comprehensive investigations to uncover how these cartels siphon resources from Kenyans and NHIF specifically. I expect this report to be available within the next seven days,” she added.
The facilities involved in this recent scandal include St. Peter’s Orthopaedic and Surgical Specialty Hospital, Afya Bora Hospital in Nairobi, Afya Bora Hospital Annex, Amal Hospital Limited, Beirut Pharmacy and Medical Centre, Jekim Hospital Nkubu Limited, Jekim Medical Centre, and Joy Nursing and Maternity in Eastleigh, Nairobi.
Outstanding payments
The CS also revealed that the Ministry has initiated a nationwide verification exercise of all payments to identify any inconsistencies that may have been used to misappropriate resources.
“This goes beyond verifying current outstanding payments,” she stated, and announced that a thorough lifestyle audit of all NHIF staff will commence immediately to ensure that their wealth aligns with their monthly income.
She emphasized that this audit, in collaboration with the EACC, will begin this month and continue throughout the year. Any identified inconsistencies will be subjected to investigations and legal action will be taken.
The CS cautioned that no organization will be allowed to conduct a medical camp without a license from the KMPDC, emphasizing that chiefs do not have the authority to grant licenses for medical camps.
Nakhumicha highlighted this requirement to ensure that there are no future instances where individuals can claim ignorance.
In response, health facilities under RUPHA stated that the association maintains a stringent vetting process for new members and enforces a strict Anti-Fraud Policy.
However, Dr. Lishenga warned that if any member of the association is found guilty of fraudulent or unethical practices, RUPHA will immediately revoke their membership and publicly announce such revocations to all members and industry partners.
