80 Health facilities under probe in regards to NHIF graft probe

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About 80 health facilities countrywide are under investigations for their involvement in possible National Hospital Insurance Fund (NHIF) claims fraud. Already, in the last two years, seven facilities have been suspended from offering services by the national health insurer in connection to possible fraud. The majority of the likely fraud cases under investigation involve overstating of claims, manipulation of the documents of non-existing hospitals and pharmacies, or cover up and non- disclosure of medical facts at the proposal stage.

The social health insurer noted that healthcare fraud, waste and abuse directly contributes to the need for higher premiums for sustainability and reduces the amount of money available to improve quality of care for beneficiaries. This has also led to the shrinking of the available benefit package to members, thereby raising barriers to accessing health while distorting equity in the financing scheme.

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