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MPs clear St. Peters hospital of wrongdoing in NHIF fraud probe

The committee ordered the closure of hospitals that benefited from the fraud.

In Summary

•Some health facilities were wrongly categorised in higher levels that did not match their capacity, infrastructure and staffing levels.

•An audit report that was brought before parliament had indicted St Peter's Orthopedic and Specialty, Jekim Medical Centre of Meru and Nairobi's Eastleigh-based Hospitals-Beirut Pharmacy and Medical Centre.

St Peter's Orthopaedic and Surgical Specility Centre
St Peter's Orthopaedic and Surgical Specility Centre
Image: HANDOUT

Members of parliament have cleared St Peters Orthopaedic and Surgical Speciality Centre of any wrong doing in the NHIF fraud probe.

The health committee lifted suspension on the Kiambu based hospital and issued the go ahead for the closure of others that have been found at fault.

An audit report that was brought before parliament had indicted St Peter's Orthopedic and Specialty, Jekim Medical Centre of Meru and Nairobi's Eastleigh-based Hospitals-Beirut Pharmacy and Medical Centre.

Following a probe and a detailed report tabled in the National Assembly, the Health Committee revealed that some of the hospitals that had been accused of defrauding NHIF also involved the national insurers beneficiaries who were allowed to demand refunds of money that they had not spent.

The committee, chaired by Endebess MP Robert Pukose, also revealed that the licensing and accreditation of health facilities and health service providers was flawed.

Some health facilities were wrongly categorised in higher levels that did not match their capacity, infrastructure and staffing levels.

“The National Insurer immediately lifts the suspension of St Peters Orthopaedic and Surgical Speciality Centre and pays the outstanding verifiable claims,” reads the final report of the committee.

Following these revelations, the committee ordered that some of the hospitals that benefited from the fraud be closed.

Lawmakers directed the Directorate of Criminal Investigations (DCI) to investigate potential collusion between service providers and the NHIF’s Claims Management Division, focusing on the division's manager and service providers involved in pre-authorising overseas treatment, within three months.

They recommended closing down Joy Nursing and Maternity Eastleigh Limited, Amal Hospital Limited, and Beirut Pharmacy and Medical Centre.

Joy Nursing and Maternity was targeted due to its location in a residential building, shared stairs with residents, lack of contractual agreements with 17 alleged orthopedic surgeons, limited space, and inadequate infrastructure, including the absence of essential medical units and specialists.

Amal Hospital was found closed during the committee’s visit, despite neighbors indicating it was operational. Beirut Pharmacy and Medical Centre was deserted, with no patients, furniture, equipment, or staff present.

For Afya Bora Hospital Annex, lawmakers suggested lifting NHIF’s suspension and paying outstanding claims, but also recommended disciplinary action against NHIF staff involved in claims verification, including claims managers, the branch manager, and quality assurance officers at the Mwea branch.

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