The Ministry of Health plans to reclassify all hospitals prior to their inclusion in the Social Health Insurance Fund (SHIF) network to eradicate fraudulent activities. This move aims to address the significant financial losses incurred by taxpayers due to fabricated claims against the National Health Insurance Fund (NHIF).
The Kenya Medical Practitioners and Dentist Council (KMPDC) will be the only body to inspect and categorise all levels of hospitals before they are contracted by SHIF.
“Some of the recommendations were to refund fraudulent claims paid, stop payment on claims in process and for the board to decide on the fate of the affected healthcare providers in line with clause 16.6 of the contracts, whether to suspend the healthcare providers or terminate the contract,” said Ms Nakhumicha.
She further told the committee, chaired by Endebess MP Robert Pukose, that the Attorney General had issued advice that during the transition period, the NHIF board should only deal with the winding up of the fund and not any other matter.
