Mombasa: Health Cabinet Secretary Aden Duale has reaffirmed the government's commitment to eliminating fraudulent and fictitious claims under Taifa Care. Speaking in Mombasa before the National Assembly's Departmental Committee on Health, CS Duale warned health facilities that they would face penalties for facilitating or tolerating fraudulent claims.
According to Kenya News Agency, since the implementation of the Social Insurance Act, 2023, over 24.4 million Kenyans have been enrolled in Taifa Care. The Social Health Authority (SHA) has empaneled 9,365 healthcare facilities, including 5,219 public, 3,650 private, and 496 faith-based institutions.
CS Duale revealed that the Digital Health Agency, in collaboration with the Kenya Medical Practitioners and Dentists Council (KMPDC) and the SHA, have identified and closed 983 non-compliant health facilities and downgraded 487. He emphasised that the actions are critical to ensuring quality care and eliminating quack practices. The CS further revealed that the SHA digital platform has eliminated over 3 million fraudulent entries from the legacy NHIF system and now operates an integrated, paperless ecosystem.
Health facilities have been urged to admit patients only within their licensed bed capacities, as SHA will not compensate for any excess admissions. 'The biggest fraud our system has detected. I want to make it clear to the people of Kenya, it's not like NHIF. Now, it's a system we can detect which doctor is treating in Malindi, Garissa, which doctor is performing,' stated the CS.
'The whole thing is about the dignity of the patient. That's why I'm bringing a bill through the committee right now, it's going through public participation called Quality of Healthcare and Patient Safety for UHC Taifa Care to work,' he added. He further affirmed that the days when patients shared beds, some sleeping on the floor, are long gone, and he would not accept that under his watch.
'We would better have even 100 good hospitals that protect the dignity and safety of our patients as citizens than having thousands that pocket money,' he said, urging health facilities to increase their bed facilities and equipment to get more patients rather than lying.
The Chairman of the Health Committee, Dr. James Nyikal, echoed the CS's sentiments, saying health facilities shouldn't charge above their capacities, urging KMPDC to continue with the crackdown. 'The reality in Kenya today, sometimes, there are more patients in the ward, particularly in public hospitals, than can be catered for, and some will sleep on the floor until we provide the money,' said Dr. Nyikal.