By Jevans Nyabiage
Claims that the Sh4.3 billion civil servants medical scheme could have been abused by National Hospital Insurance Fund ( NHIF) officials raises questions about the Fund’s integrity to be entrusted with contributors’ millions.
Even as the ministry of Medical Services launches investigations into fraud allegations, questions have been raised on whether NHIF can roll out a corrupt-free comprehensive medical cover under it’s current state and structure.
New NHIF rates that were suspended a week ago for three months were earmarked to finance an outpatient scheme for regular members, and a pilot project for envisaged universal healthcare for all Kenyans. The Fund is also administering a Sh5.2 billion scheme for Kenya National Union of Teachers.
Under the civil servants and teachers scheme, the Fund offers outpatient and inpatient insurance services.
Financial Journal has established that a policy gap may have opened up NHIF to abuse in which millions of shillings are claimed to have been siphoned.
Under the current set-up, NHIF is both a regulator and an administrator. Its mandate is to register and receive contributions, settle members’ bills in hospitals and set criteria for accrediting hospitals. NHIF also regulates contributions payable to the Fund.
The Fund was established in 1966, under Cap 255, to be run by an advisory Council appointed by minister of Health. In 1998, Cap 255 was repealed and replaced by the NHIF Act, which transformed the Fund to a State corporation managed by a Board representing various bodies and interest groups.
The plan to provide medical cover to civil servants and teachers, analysts say, is noble, but may be seen as jumping the gun or trying to pre-empt change and wide consultations in development of the healthcare financing sector.
NHIF chief executive officer Richard Kerich maintains Fund had conducted a successful pilot run prior to the implementation of an outpatient services. “The project was bound to succeed as we had operated it for eight months in Mumias and Nairobi before rolling it out nationwide,” he said. “We were ready since 2009 and we knew that the services will be enjoyed by all members.”
“This is in line with the new Constitution which guarantees everyone the right to health care,” Kerich said, adding that his firm is committed to offering quality outpatient and inpatient services.