Health

Senate cut fines, jail term for fraudulent use of NHIF

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The National Hospital Insurance Fund (NHIF) in this picture taken on Tuesday, October 26, 2021. PHOTO | DENNIS ONSONGO | NMG

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Summary

  • The Senate in its review of the National Hospital Insurance Fund (Amendment) Bill, 2021 has proposed a reduction of the fine to Sh100, 000 from the Sh1 million approved by the National Assembly and lowered the jail term to six months from two years.
  • MPs are however likely to oppose the reductions given that they sponsored the Bill that seeks to impose stiff penalties on fraudsters who continue to bleed the State-backed insurer.

Senators have reduced fine and jail term for fraudsters impersonating National Hospital Insurance Fund (NHIF) enrolled members in a move that is likely to spark off opposition from the National Assembly.

The Senate in its review of the National Hospital Insurance Fund (Amendment) Bill, 2021 has proposed a reduction of the fine to Sh100, 000 from the Sh1 million approved by the National Assembly and lowered the jail term to six months from two years.

MPs are however likely to oppose the reductions given that they sponsored the Bill that seeks to impose stiff penalties on fraudsters who continue to bleed the State-backed insurer.

Parliament passed the Bill in September and doubled the fine from Sh500, 000 citing increased fraudulent claims that have seen NHIF lose an estimated Sh16.5 billion annually.

Impersonation involves NHIF members giving their cards to patients not eligible for treatment using the State insurer’s services while hospitals have also been lying about their bed numbers.

“Clause 35 of the Bill be amended by deleting the words ‘one million shillings or to imprisonment to a term not exceeding 24 months and substituting thereof the words ‘one hundred thousand shillings or to a term not exceeding six months,” Senate says in the amendments of the Bill.

Eyes will be on MPs when they start debating Senate’s proposals given that the two houses have in the past been locked in disagreements that have derailed passage of critical money bills in the past.

The Bill must get approval of both houses in line with the law given that all Bills related to money require agreement of MPs and Senators.

The State is racing against time to roll out an NHIF-backed universal healthcare, which is one of President Uhuru Kenyatta's key goals before he exits office next August.

Kenya has prioritised the attainment of universal health coverage (UHC) by 2022 after years of false starts.

The State had pushed for a Sh10 million fine or three years in jail or both for those found guilty of impersonation in the wake of the increasing losses but Members of Parliament reduced the penalties while passing the Bill on Tuesday.

The fraud usually involves forgery of documents, specifically MRI and CT Scans. This has been rampant due to lack of biometrics to identify members and their dependents.

In May, NHIF flagged claims forwarded by a hospital in Nairobi involving a woman who tried using her daughters’ card claiming services worth Sh1.246 million, highlighting the gravity of fraud on the State-backed insurer.

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