•The country has in the recent been rocked with scandals of health facilities making claims for services they did not offer to patients especially surgeries.
•However, with the ongoing health facility survey, all hospitals will be mapped according to their levels and the services they offer.
Image: FILE
It might now be hard for hospitals across the country to make fraudulent medical claims after the facility census is completed.
The country has in the recent been rocked with scandals of health facilities making claims for services they did not offer to patients especially surgeries.
However, with the ongoing health facility survey, all hospitals will be mapped according to their levels and the services they offer.
The Ministry of Health on Monday begun an assessment of hospitals and health centres countrywide.
This means the government through the assessment report will be able to tell the capacity and ability of each facility to provide specific health services.
Health CS Susan Nakhumicha has revealed that once out, the ministry will be able to either demote or promote the facilities within the levels and decide which ones to work with NHIF.
“We are doing facility level of service assessment. What is it going to do to NHIF? One of the things is that we are going to document the real health facilities and their level of service,” she said.
“So when it comes to claiming to NHIF we already know the facilities that we have in the country from this assessment. We know what level of service they are able to provide so if you are to claim that you did surgery then we indeed know that you have the capacity and the capability to do surgeries,” she added.
The 500 trained and equipped research assistants will do the Health Facility Census targeting at least 15,000 public and private health facilities.
The exercise which targets both private and public seeks to find out the infrastructure in the facilities, the equipment and machines and the human resources available to run the facilities.
The exercise is expected to go on for the next two weeks and close on August 25 in what the DG Patrick Amoth said was a prerequisite for the launch of the Universal Health Coverage.
"We have put in place a robust data validation system so the data will stand the scrutiny of time," Amoth said.
MPs have since opened a 90-day probe into alleged fraudulent claims and payments to health facilities in an effort to unravel the circumstances that led to the payment of fictitious claims.
Nakhumicha in June suspended health centres, suspended eight NHIF branch managers in regions hit by fraud allegations and ordered a thorough probe into the payment of the fraudulent claims.
She maintained that she will do everything humanly possible to restore sanity in the health sector. She revealed how small hospitals conspire to defraud the fund.
The CS said medical claims from some of the small hospitals in various parts of the country show they seem to be performing a higher number of surgeries than the country’s referral hospitals.
“In the next few days, I will be unveiling the preliminary report. Equally, I will be unveiling what we have done as a ministry. The reward and punishment system will also be known,” the CS said.
“The report also entails who gets maybe demoted to another level and who do we say for this specific facility NHIF is not going to work with you because you are fraudulent. That is the report we are going to release in the next few days.”
As part of the effort, the ministry embarked on a nationwide verification of medical claims lodged by health facilities under the NHIF.
The verification process will ensure any inconsistencies that may be point to abuse of resources and theft cross the country are flagged
Rogue providers who are in business of defrauding the fund via fake medical claims will also be weeded out.