Joy Nursing and Maternity Home has dismissed accusations of transporting patients from various regions to their premises for surgical interventions.
At the same time, the Eastleigh-based facility refuted allegations of offering inducements in exchange for biometric registration related to surgical procedures.
Kennedy Otieno, the hospital administrator, cleared his facility of any involvement in fraudulent claims at the National Health Insurance Fund (NHIF).
Appearance before the National Assembly's Committee on Health, Otieno said his facility does not have a contractual agreement with Jekim Hospital Nkubu Limited or its affiliated institution, Jekim Medical Centre.
The committee is conducting a public inquiry into financial misappropriations and other malpractices at NHIF.
The committee is looking into allegations that patients were taken to Jekim Hospital Nkubu Limited for X-rays and then transported to Joy Nursing and Maternity for further treatment, with no surgeries conducted.
“When a patient comes to the hospital I don’t ask them, for instance, where are you coming from or reside. Patients are personal clients of visiting doctors,” he added.
Otieno added that he could not ascertain whether the patients were induced or not.
Robert Pukose, the chair of the committee, raised concerns about 201 patient files worth Sh25,495,020 that could not be traced during NHIF investigations.
Otieno defended the facility by explaining that doctors do not necessarily take patient files home. He noted that when the hospital was temporarily shut down, there were no staff members available to retrieve the files.
When the NHIF team investigating fraudulent payments visited the facility, some files were missing.
“Out of those files they carted away, at least 201 patient files worth Sh25 million from patient medical records cannot be retrieved, where are they,” posed Pukose.
The facility also faced a litany of allegations including that of seeking pre-authorisations that did not align with the diagnosis.
“When asking for pre-authorization for a surgical case, you make a claim for a surgical case. But upon reviewing the files, it was found that there was no surgery conducted; it was a medical case that did not require surgery,” questioned Pukose.
Otieno responded by stating that the doctors who write the authorization forms are responsible for the diagnoses.
