NAIROBI, Kenya – The government has defended its new healthcare scheme, Taifacare, against criticism, saying it is tackling widespread fraud that plagued the now-defunct National Health Insurance Fund (NHIF).
State House Spokesperson Hussein Mohamed, in a statement posted on X, said that nearly 40% of claims under NHIF were fraudulent.
He accused some health facilities of resisting reforms under the new Social Health Authority (SHA) because they benefited from a system that allowed unchecked payments.
“Under SHA, an empanelled and contracted health facility is paid only for actual, documented, and verified patient visits within the prescribed tariff,” Mohamed said.
Taifacare is addressing the fraud that plagued the former NHIF system, where nearly 40% of claims lodged for payment were fraudulent.Under SHA, an empanelled and contracted health facility is paid only for actual, documented, and verified patient visits within the prescribed…
He alleged that some facilities preferred the previous system, where payments were made without verification, leading to fraudulent claims for nonexistent patients and medical procedures.
Speaking in Kakamega County on Tuesday, President William Ruto reinforced the government’s stance, declaring, “The stealing is over! Move on!”
The overhaul of NHIF into SHA has sparked debate, with some healthcare providers warning that the transition could disrupt services.
However, the government insists that the reforms will streamline healthcare financing and eliminate loopholes that enabled corruption.