- In the 2017-19 contract, the ministry paid Sh4.7 billion to NHIF for the comprehensive medical cover.
- Included in the deal was an excess amount of Sh200 million to cushion members who might have exhausted their coverage.
Image: NHIF
The national health insurer has denied claims of holding onto Sh200 million that has seen the Interior ministry threatening to withhold subscription to the agency.
National Hospital Insurance Fund chief executive Peter Kamunyo on Thursday told MPs that the money being claimed by the ministry was indeed utilised, leaving a balance of only Sh5 million.
Kamunyo was before the Public Accounts Committee chaired by Ugunja MP Opiyo Wandayi to respond to claims that the national insurer was still holding some Sh200 million that was an excess payment on the National Police Service comprehensive medical cover.
In the 2017-19 contract, the ministry paid Sh4.7 billion to NHIF for the comprehensive medical cover.
Included in the deal was an excess amount of Sh200 million to cushion members who might have exhausted their coverage.
The amount was to be refunded at the end of the contract if no one exceeded their limit during the cover period.
Auditor General Nancy Gathungu in her 2017-18 audit report said there was no evidence of any employee exceeding the limit, hence, the money should have been refunded.
“This amount was refundable at the end of the contract but was not refunded when the contract came to an end. Consequently, it was not possible to determine whether the National Police Service got value for money from the amount of Sh200,000,000 that was due for refund at the end of the comprehensive medical cover contract," Gathungu said in her report.
But appearing before the oversight team yesterday, Kamunyo said the amount was exhausted tabling the details before the committee.
“For inpatient care for the lower job group there was a utilisation of Sh205,554,081, for C-section utilisation was Sh9,642,567, for optical was Sh12,179,202, dental Sh8,319,324. So for the total fund utilisation for the year 2018/19 was Sh237, 238,889 leaving accumulative balance of Sh5,326,427,” the CEO said.
“We have documentary evidence of the people who had used the amount beyond their limits.”
The CEO was however hard pressed to explain why it took the agency too long to give details on how the Sh200 million was utilised and the details of the beneficiaries who surpassed their limits.
MPs Wandayi, Aden Duale (Garissa Township) and Ojiambo Oundo (Funyula) demanded to know why NHIF could not provide the details in time forcing the auditor to raise the matter in her report.
In his response, the CEO explained that the agency only provided the aggregated returns of the whole Sh4.7 billion and needed time to reconcile and account for the excess amount.
“The data captured for members was included as one amount so it required reconciliation which our team was working on hence the delay,” Kamunyo explained.
-Edited by SKanyara