Parliament has doubled the fine for fraudsters caught impersonating National Hospital Insurance Fund (NHIF) enrolled members in a bid to protect the scheme’s revenues that have increasingly been targeted by cheats.
Persons found fraudulently using the scheme to settle medical bills face a Sh1 mllion fine or a two-year jail term or both after Members of Parliament on Tuesday passed the changes to the NHIF Act of 1998 and imposed the stiffer penalties to tackle fraudulent and fictitious claims from individuals and hospitals that have seen the State-backed insurer loses up to Sh16.5 billion annually.
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.
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.
“We have been experiencing fraudulent cases and attempts worth a lot more which is quite disappointing,” NHIF chief executive Peter Kamunyo said.
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.