EACC Unveils Crucial NHIF Graft Report Exposing Systemic Loopholes, Financial Mismanagement
On Tuesday 5th Feb, the Ethics and Anti-Corruption Commission (EACC) released a long-awaited report on the National Health Insurance Fund (NHIF), highlighting systemic vulnerabilities that have enabled substantial financial mismanagement within the institution. Spearheaded by the newly appointed EACC Chair, Bishop David Oginde, this thorough audit is intended to catalyze necessary reforms by exposing weaknesses in NHIF's systems, policies, procedures, and practices that have facilitated the misuse of public funds.
The NHIF, set to fully retire later this year, has been losing taxpayers money due to weak data management systems.
According to the report, user accounts linked to service providers had unrestricted access to the Fund's system and all data pertaining to facilities or beneficiaries.
In July 2022, the Ethics and Anti-Corruption Commission (EACC) disclosed that the insurance scheme incurred a significant loss of Sh29 million, heightening existing public apprehensions regarding the scheme's integrity.
The anti-corruption agency stated that the fraud was perpetrated by certain staff members whose identities they withheld. During that period, these employees unlawfully accessed the fund's infrastructure, resulting in the unauthorized addition of services to healthcare providers (HCPs) within the system.
"Three members of staff irregularly amended member details occasioning a loss of Sh29,958,642 to the fund," the report reads.
"Active third-party user accounts with access to enterprise systems as evidenced in reviewed system audit logs... added 12 specialized services to one HCP on 14th July 2022."
The EACC team handed over the 72-page report to NHIF management and the board of the newly formed Social Health Authority (SHA) at the headquarters in Nairobi on Tuesday.
Bishop Oginde said the report will help NHIF and SHA streamline their operations during their transition period.
As outlined in the report, the breach in data integrity might have led to favoritism, bribery, and extortion, all exacerbated by a deficiency in accountability measures.
"We found that the systems were such that they lend themselves to people who are corrupt to take up the system."
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| Bishop Oginde during the launch of the NHIF Graft Report |
To rectify the deficiencies, Medical Services Principal Secretary Harry Kimtai stated that they would utilize technology to close the identified gaps, such as addressing delays in the approval of empanelment, which currently require 15 to 20 months.
"No more manual claims. We are starting in a new slate. It will not take more than 30 days before your claims are paid," he assured.
On the question of transfer of NHIF personnel to SHA, the PS noted that all staff members will be vetted before transitioning to the new scheme to weed out those implicated in graft.
Oginde further stated that the staff deemed corrupt "will still be pursued in their individual capacity... they are personally responsible... those cases will not be lost."
At the heart of the EACC's report lie its proposals, crafted to revolutionize NHIF's governance mechanisms and operational protocols, aiming to deter future corruption occurrences. These recommendations span various reforms, ranging from enforcing stringent supervision and accountability protocols to restructuring NHIF's policy frameworks. The objective is to strengthen the fund's resilience against corruption by addressing the identified vulnerabilities and fostering a governance system characterized by transparency, efficiency, and accountability in managing public funds allocated for health insurance.
The NHIF 57-year legacy has been tainted by graft, mismanagement and fraud, this moment underscores the vital necessity for ongoing vigilance and reform efforts to combat corruption and protect public resources, ensuring they are utilized for their intended objectives.
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