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Opinion & Analysis

EDITORIAL: Punish rogue hospitals fleecing NHIF members

NHIF chief executive Geoffrey Mwangi. FILE PHOTO | NMG
NHIF chief executive Geoffrey Mwangi. FILE PHOTO | NMG 

The National Hospital Insurance Fund’s (NHIF) recent decision to confer more benefits to members through higher contributions, has no doubt been a relief to millions of Kenyans who had to dig deep into their pockets to access medical care.

But as all things Kenyan go, some hospitals have started taking advantage of that new dispensation to lodge unsupported claims.

The unscrupulous health facilities have seen a fund into which they can dip their fingers and steal, but the NHIF management has made the right move by stopping them in their tracks even though some appear to have already been paid for some of the fake claims.

We urge the fund to remain diligent in interrogating the claims and establishing their authenticity as it is clear that some of them are bent on fleecing members of the scheme.

The facilities not only inflate bills, but also ask to be paid for surgeries and other medical processes that never took place. That is as callous as it can ever be in the eyes of hard-pressed scheme financiers, who can ill-afford the more expensive private medical schemes.

It should properly be labelled white collar theft.

As a countermeasure, the NHIF management should seek to have these companies or health centres repay what is proved to have been irregularly paid to them. Many medical facilities continue to prove what the public often suspects of them.

That they regularly fake bills, inflate them, duplicate them, overmedicate or give patients unnecessary drugs or subject them to processes or surgeries that are unnecessary.

Many have been accused of prescribing expensive drugs from certain manufacturers even where generic drugs could effectively do the same job and at a much lesser cost.

Not only should the fund stop the illegal payments, it should also blacklist medical institutions that have stolen from it.

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