By: Eric Wanjala
National Assembly Health committee led by its chair Hon Pokose has officially cleared of allegations regarding fraudulent claims under the national insurance health cover. St Peters hospital had faced scrutiny over allegations that it had improperly billed the national insurance program for services not rendered or exaggerated in nature.
Following a thorough investigation by national assembly health committee, including audits and reviews of billing records, it was determined that the hospital had adhered to all guidelines and protocols set forth by the national insurance health cover. The committee has confirmed that there was no evidence of deliberate wrongdoing or fraudulent activity on the part of the hospital, however they are required to pay for
“The National Insurer immediately lifts the suspension of St Peters Orthopaedic and Surgical Speciality Centre and pays the outstanding verifiable claims,” reads the final report of the committee.
Following these revelations, the committee ordered that some of the hospitals that benefited from the fraud be closed.
In response to the findings, St Peters Authopedic hospital which is based in Kiambu County expressed relief and reaffirmed its commitment to maintaining transparency and integrity in all financial dealings. The hospital’s administration emphasized its ongoing efforts to provide high-quality healthcare services while ensuring compliance with regulatory standards.
This development marks a significant milestone for the National Assembly health committee, as it underscores the importance of accountability and adherence to regulatory requirements within the healthcare sector.
At the Moment the Director of Criminal investigation is investigating potential collusion between service providers and the NHIF’s Claims Management Division, focusing on the division’s manager and service providers involvement in pre-authorising overseas treatment.
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