80 hospitals under probe for defrauding NHIF

Some 80 health facilities across the country are being investigated for possible fraud against the National Hospital Insurance Fund (NHIF).

Already seven facilities have been suspended by NHIF for overstating claims, manipulation of documents of non-existing hospitals and pharmacies and non-disclosure of medical facts.

The NHIF Benefits and Contracting Manager, Gilbert Osoro, noted that healthcare fraud has contributed to the reduced amount of money available to improve quality of care for beneficiaries.

Osoro, however, said the Fund has invested in new futuristic technology to curb the increasing menace.

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Osoro also stressed the need for healthcare providers to work with NHIF in minimizing fraud.

Osoro, however, said in curbing the increasing vice, the fund has invested in new futuristic technology. The system to replace the pay and chase for recovery which it says had loopholes for possible fraud and abuse.

NHIF says it paid Ksh1.9 billion for medical claims in 2016 alone and believes it could have lost over Ksh500 million the same year to fraudsters.

Ms. Judith Otele, who is also an official at NHIF expressed similar sentiments.

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