CS Health blames acting NHIF boss for Sh1.6b claims scam

Written by on 21 June 2023

Health Cabinet Secretary Susan Nakhumicha yesterday appeared to throw the acting CEO of the National Health Insurance Fund (NHIF) under the bus, directly linking him to the Sh1.6 billion claims scandal.
When she appeared before the National Assembly Committee for Health yesterday, Nakhumicha claimed the acting CEO, Dr Samson Kuhora, was the one in charge of the claims department which is tasked with making the payments in question.
Asked by the committee chairman Robert Pukose whether she had inquired about Kuhora’s previous position before elevating him, Nakhumicha said she was well briefed by her officers prior to the appointment.

“The acting CEO was the senior most officer. The other option available was hiring from outside which would have taken a little longer,” said the CS.
She added: “Bringing in a different person or recruiting someone from outside would have taken longer due to the recruitment process.”
Pukose disagreed with the CS, saying there were more senior officials at NHIF and in the Ministry who could have acted as the CEO. “You don’t choose someone who has been in charge of claims at NHIF to go out and do a cover-up for himself,” Pukose argued.
Kuhora was the Head of Benefits and Claims when he was appointed acting CEO.

Nakhumicha also revealed that one of the health facilities suspended over its involvement in the scandal handled more surgeries than all the major hospitals in the country combined.
The CS said the problems bedevilling the Fund were baffling, adding that an audit she has directed the board to initiate will reveal more.
Defending her decision to suspend branch managers of the NHIF after rogue hospitals allegedly stole millions of shillings through suspect medical camps targeting elderly patients, the CS said the health facility in question was handling more surgery cases than top hospitals, including Kenyatta National Hospital.

“The facility is one of those that I suspended. It had more surgeries than even the KNH, Moi Referral, and the top private hospitals combined,” Nakhumicha told the MPs.
The CS said she had given the suspended facilities 24 hours to vacate patients.
Nakhumicha said the decision to suspend the facilities would create a conducive environment for investigations.
“Why branch managers? Branch managers are the people who are tasked with the responsibility of supervising, monitoring, and evaluating facilities within their purview, and reporting any issues to the headquarters,” Nakhumicha said.
“When claims are made, branch managers review the claims before they reach the HQ,” she explained. “I will stand by my decision; I will lead from the front. We may make some mistakes, but we will learn from them and move on. However, these are not decisions that need to be delayed. They have to be taken.”
But the committee disagreed with the decision to suspend the branch managers, saying it was “too little, too late”.

The CS, however, urged the committee to support her actions, insisting that in order to address the corruption at NHIF, they had to start somewhere.
She also called on investigative agencies to conduct a thorough probe.
“By the time we make final decisions, they will be based on the facts brought out by the investigations,” she said.
Regarding concerns that her Ministry is plagued by scandals, especially in regard to Kenya Medical Supplies Agency (Kemsa) and NHIF, the CS the culprits must be brought to book.
“As much as we have systems in place, it is the same people who go around those systems to defraud public resources, so we must deal with the culprits,” she said.
Nakhumicha said her Ministry had commenced investigations into the NHIF scandal even before the media expose.

The CS said the rot in the NHIF payment claims system was not limited to the six facilities that were highlighted in the expose.
“We have a big problem. It is shocking that over 60 per cent of payments from NHIF go to private facilities. I am yet to be convinced that smaller private facilities perform more surgeries than KNH and all the public facilities combined,” the CS said.

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