After grilling by the House of Committee, the Acting NHIF ICT Director Washington Okoth, assured MPs that the system would be upgraded to seal loopholes that had been exploited to commit fraud. The questioning came while the MPs were looking into why, in the last two fiscal years, the National Health Insurance Fund (NHIF) paid insurance companies Sh9 billion in Work Injury Benefit Act (Wiba) premiums, but only utilised Sh200 million to resolve patient claims.
The MPs hinted at the likelihood that some crooked employees colluded with the insurance companies to swindle Kenyans of their money while questioning NHIF CEO Samson Kuhora.
The Health Committee of the National Assembly also wanted to know why the Fund chose to pay such high premiums at the expense of Kenyans.
“It is not practical to be paying Sh9 billion to insurance companies whereas the payout to patients is way less. Clearly the scheme is being used as a cash cow for some people,” said committee chair Robert Pukose.
Mr. Mathenge highlighted a rise in claims from Sh833 million in the fiscal year 2020–2021 to Sh2 billion in the fiscal year 2022–2023 and wanted the director to clarify on the issue.
Dr Kuhoro while agreeing that the reimbursement to patients was inadequate, Kuhora pointed to the Covid-19 outbreak as the cause of the increase in premium payments since “the institutions had to support government officers who sought their intervention.”
The committee, however, criticised the NHIF director for allegedly lying while under oath. He stated that “NHIF did not pay for Covid-19 because the government was responsible for doing so.”
In the meantime, the House committee yesterday criticised NHIF’s top management over the organization’s intended purchase of a new Sh4.2 billion biometrics system, replacing its present Sh1.6 billion system hence the directed that the fund upgrade its biometric systems and not procure a new system as this would be costly.
The committee’s decision came after acting ICT Director Washington Okoth said the gaps raised regarding the system can be solved through an upgrade.The official told the committee that there is no need to buy an extravagant system as the current biometric system is new and up to date with technological standards.
“The system which was put in place in 2018 encompass Electronic with encrypted communication between providers and the fund. The technology has eliminated fraud impersonation and reduced paper work across its countrywide branches,” he said.