The woes facing the embnattled National Hospital Insurance Fund – (NHIF) have continued to hot new heights as civil servants across the country have joined the campaign to ditch the insurer.
A team formed to investigate complaints against the NHIF-managed Comprehensive Medical Insurance Scheme for Civil Servants (CMSCS) has revealed that the scheme offered a raw deal for majority of Government workers.
The report, which was also ran by The Standard, also uncovered fraudulent activities by healthcare providers, including impersonation of workers’ dependents to lodge fake claims and forcing patients to buy medical supplies provided under the scheme, The paper reports.
Subscribers feel that the NHIF is yet to accomplish it’s provisions as agreed by the clients as majority of the users are reportedly denied treatment at night and made to pay for certain procedures.
The Union of Kenya Civil Servants (UKCS) had earlier questioned the capacity of NHIF to manage the medical scheme.
A few days ago, this website ran a story exposing the challenges many patients go through when it comes to being approved by the NHIF to fund their medication.
The investigative has further revealed many more embarrassing provisions including lack of proper equipped facilities where patients can seek medication despite being fully covered by the scheme.
“Contracting facilities lack the capacity to offer services to members under the capitation, leading to poor quality of services to members and their dependents,” the report read as quoted by the Standard.
Civil servants had earlier this year initiated a plan to ditch the NHIF but the insurer has not shown any signs of improving their services.
However, the Ministry of Public Service, through the Principal Administrative Secretary Mary Kimonye, in a letter dated June 6, 2019, has detailed a raft of changes to address the grievances by the civil servants.
Among them, The Standard says, is that the NHIF should review and reduce the documentation required for identification and verification of dependents at the point of seeking services.
The ministry also recommends that NHIF develops benefit packages and issue clear guidelines on how and where to access treatment for specialised and chronic illnesses but this could be too late especially after damage has already been done.