RFH Healthcare, Four Other Private Hospitals Under Probe Over Multimillion NHIF Fraud

RFH Healthcare is amongst the five healthcare providers that have allegedly been engaged in a multimillion National Health Insurance Fund (NHIF) scam. This is according to a petition filled by an activist to the Meru County Assembly.

Mr Salesio Thuranira has accused five private hospitals over claims of swindling elderly residents in the pretence of treating arthritis.

He has named Afya Bora Hospital Annex, RFH Healthcare, Joy Nursing & Maternity, St Peters Hospital and Jekim Hospital based in Mwea, Nairobi and Meru, as institutions that should be probed.

“The hospitals … are well coordinated in an illegal scheme of treating Meru residents aged 44 years and above, in the pretence of curing arthritis by surgery or unknown injections,” Mr Thuranira states in the petition.

He claims that the that the hospitals have been working with a woman identified as Winfred Kathure who recruits patients before they are ferried to Nairobi for the alleged treatment.

“Winfred goes around the villages and scouts for elderly people suffering from arthritis and holders of active NHIF cards. She lures them without the knowledge of their relatives to attend surgeries in the hospitals. For every client she convinces, she is paid Sh1,500,” the petition reads.

Mr Thuranira claims that some patients were being admitted to hostels without proper amenities, where they get injections before being discharged.

“Upon discharge, they usually receive a message from NHIF indicating that Sh300,000 has been deducted for surgery,” he states.

In supposed of his allegations, the activist has listed six people in his petition that have supposedly fallen prey and swindled by the hospitals.

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He now wants the assembly to wants the assembly to summon the proprietors of the five hospitals to answer to the issues raised in the petition as it is a matter of public interest.

RFH Healthcare owner Dr Maxwell Okoth.

Meru Assembly Speaker Ayub Bundi, who read the petition to the members, directed the Health committee to investigate the allegations and table a report by May 31, 2023.

National Health Insurance Fund (NHIF) loses Sh10 billion every year through fraudulent claims.

NHIF Chief Executive Officer Peter Kamunyo said the funds are lost through impersonation and fictitious claims by public and private hospitals thus denying millions of deserving Kenyans quality health care.

The CEO said some hospitals present claims of major surgeries when a patient has undergone a minor procedure.

Last year, the Ethics and Anticorruption Commission (EACC) renewed its efforts to deal with dozens of hospitals involved in corrupt deals touching on NHIF claims.

In addition to that, the anti-graft body disclosed that it was investigating individuals who connived with the hospitals to defraud the fund of millions of shillings through fictitious claims.

In the last couple of years, some private hospitals were in the limelight after it emerged that they had defrauded NHIF through fake medical claims.

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