St Peter's hospital cleared of fraud allegations

Health & Science
By David Njaaga | Jun 24, 2024
St Peter’s Orthopaedic and Surgical Speciality Centre. [Standard, File]

A report by the National Assembly committee has cleared a city hospital of allegations regarding fraudulent claims under the national insurance health cover.

St Peter’s Orthopaedic and Surgical Speciality Centre in Kiambu faced accusations of improperly billing the National Health Insurance Fund (NHIF) for services not rendered.

 The allegations involved substantial sums, part of an estimated Sh1.54 billion paid to various health facilities.

Following an investigation by the Departmental Committee on Health, chaired by Endebess MP Robert Pukose, it was determined that St Peters had adhered to all guidelines and protocols set by the NHIF.

The committee found no evidence of deliberate wrongdoing or fraudulent activity by the hospital.

"The National Insurer immediately lifts the suspension of St Peters Orthopaedic and Surgical Speciality Centre and pays the outstanding verifiable claims," reads the committee's final report.

At the same time, the committee recommended the closure of several other hospitals found to have benefited from fraudulent practices including Joy Nursing and Maternity Eastleigh Limited, Amal Hospital Limited and Beirut Pharmacy and Medical Centre,  

The committee cited various operational deficiencies and fraudulent activities against the facilities.

The committee also directed the Directorate of Criminal Investigations (DCI) to investigate potential collusion between service providers and the NHIF’s Claims Management Division.

The probe will focus on the division's manager and those involved in pre-authorising overseas treatment.

St Peters Orthopaedic and Surgical Speciality Centre in its response reaffirmed its commitment to maintaining transparency and integrity in all financial dealings.

The hospital's administration emphasised ongoing efforts to provide high-quality healthcare services while ensuring compliance with regulatory standards.

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