National Hospital Insurance Fund is rolling out new technology to safeguard their system from fraud.
Nicodemus Odongo, the funds acting chief executive officer, said the system will also improve service delivering. He warned that action will be taken against errant staff, and health facilities engaging in fraud will be suspended and officers prosecuted.
The fund called on the facilities to be on the forefront of safeguarding achievements made in expansion and delivery of quality health-care services to the NHIF members.
Working together with the Fund, Odongo said Healthcare providers can further safeguard the gains towards continual improvement on coverage and quality of healthcare services. Encouraging healthcare providers to report any fraudulent activity to the nearest NHIF offices or to the police.
“NHIF is thus making calculated moves to counter the rampant occurrences of possible fraud by incorporating the Enterprise Risk Manager (ERM) to systems that will be conducting a holistic audit to pre-empt risk areas,” he said.
“Other measures include suspending Health facilities that are caught in fraud and taking action on employees engaging in fraud activities with health facilities,” he added.
To achieve sustainability, he said NHIF banks on health facilities as key players to safeguard health care programs and take a lead in the integrity of health insurance and quality services.
“To sustain the various health programs to Kenyans, Health Care Providers are advised to desist from any un-procedural activities that may lead to fraud and are encouraged to report any such cases,” he said adding that in the event that such happens, the Fund will take necessary action in accordance with the law and the contracts.
The health care providers equally he said have a responsibility to ensure the sustainability of the national health insurance cover by strict adherence to the law and contractual obligations.