NHIF 2023 audit summary

NHIF managers are on the spotlight following a scathing new audit report that exposes the rot at the national health insurer.

Taxpayers could have lost billions in irregular payments that have been flagged by Auditor General Nancy Gathungu in a new report.

Management failed to explain expenditure of more than Sh7.4 billion, as per the report for the year ending June 30, 2023.

An analysis of bills owed to healthcare providers revealed Sh2.9 billion in respect of duplicate healthcare providers, with the same name but different outstanding amounts and different hospital codes.

Of the amounts flagged, cases of duplicate payments to the tune of Sh247 million were claims passed off as paid to ‘the same patient’.

It has emerged that the NHIF management paid Sh51 million for one patient who was admitted to different hospitals at the same time.

A review by the auditor revealed that the amount was for 2,808 claims purported to be for the same patient.

---