Kenya Association of Private Hospitals Urges Balanced Approach in Addressing Medical Insurance Fraud Allegations.
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Kenya Association of Private Hospitals Urges Balanced Approach in Addressing Medical Insurance Fraud Allegations.

The Kenya Association of Private Hospitals (KAPH) has today released a statement on allegations of fraudulent conduct by private healthcare providers indicating that no effort should be spared in eradicating medical insurance fraud in the country’s health sector.

However, KAPH now says that a number of the immediate measures taken constitute administrative jurisdictional overreach.

They further added that the allegations may be detrimental to the outcome of the inquiry launched if the innocence of the parties concerned is to be presumed until undeniable evidence of perpetration of the alleged acts is cited as evidence.

KAPH also said in the statement that the allegations from a media expose on the facilities have not been given the right of reply or a hearing as stipulated in The KMPDC ACT cap 253 section 20 and it is, therefore, wrong to suspend them first and investigate while there are many patients and staff who depend on these facilities.

The statement further questioned the power that National Health Insurance Fund wields is what creates avenues for corruption and collusion between NHIF staff and service providers. They now propose that some of the functions of NHIF be given to other bodies so as to have checks and balances.

In their view, It is crucial that any inquiry conducted on the allegations involve other investigative agencies with the requisite capacity to accord them impartiality and legitimacy. Only then will this incident act as a deterrent for those contemplating similar acts in the future and aid KAPH’s pursuit of universal health coverage in Kenya.

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