Hospital stops attending to students after row with NHIF

The Virgin Hospital proprietor Kenneth Maguta who said that they have stopped giving services to students under the Edu Afya scheme after the Murang'a NHIF branch stopped them from making payment claims. PHOTO | NDUNG'U GACHANE | NATION MEDIA GROUP

What you need to know:

  • NHIF suspended payments to the hospital to investigate whether students said to have been treated at Virgin Hospital were genuine.
  • The hospital is the only one that has been taking its services to the schools.
  • The hospital wants investigations launched to find out whether NHIF had an ulterior motive when it stopped the payment claims.

A disagreement between a private hospital in Maragua, Murang’a County and the National Hospital Insurance Fund (NHIF) Murang’a branch has affected services for students in the area.

The stand-off started in November last year when the NHIF wrote a letter to The Virgin Hospital to temporarily suspend its payment claims to the fund to pave way for investigations on the high number of the students attending the hospital.

In a letter dated November 16, 2018, NHIF suspended payments to the hospital pending investigations to establish whether the students said to have been treated there were genuine.

LETTER

“Upon perusing through records held by yourselves, facts came out clearly which gave rise to suspicion that claims under Edu Afya scheme being submitted to NHIF for payment or being prepared for submission could either be fraudulent or not warranted.

“A branch claims committee resolved to temporarily suspend payment of the claims and do further investigations to establish the truth,” read the letter read signed by NHIF Murang’a Branch Manager David Kimanzi and seen by the Nation.

It is the letter that prompted the management of The Virgin Hospital to stop giving services to schools in the neighbourhood where it had been conducting mobile clinic services.

MOBILE CLINICS

The hospital is the only one that has been taking its services to the schools, a move that favoured by the institutions as it was convenient to students facing transport challenges.

Ichagaki Boys High School is one of those that have been affected by the stalemate, forcing it to send home four students who have fallen ill.

Deputy Principal Mwangi Gachaga told the Nation that like most schools in Maragua, they prefer the private hospital due to availability of drugs and also for its mobile clinic services.

CHRONIC ILLNESSES

“Some of our students suffer from chronic illnesses and this affected them when the hospital suspended its services. We don’t have a vote head for transport to take students to Maragua or other hospitals and whenever we take them to public hospitals we often find they have no medicine,” Mr Mwangi said.

He added that concerns by NHIF the private hospital has been attending a huge number of the students could be attribute to its mobile services.

But the county NHIF manager said they did not stop the hospital from attending to students but instead stopped it from making payment claims to NHIF.

“We have only suspended the claims by the hospital (in order) to verify the huge claims and we are within our timelines of three months. I don’t know why the schools don’t want to take the students to other facilities if The Virgin Hospital has suspended its services,” Mr Kimanzi told the Nation.

FINALISING PROBE

He said they are finalising the investigations which will include going to the schools and talking to students to find out whether they received services from the hospital.

But the hospital’s proprietor Kenneth Maguta said the letter from NHIF indicated that the claims they had submitted and those that they intended to submit had been suspended and hence they stopped their services to schools.

“We could not continue to offer the services because of the letter and the fact that they owe the facility Sh3.9 million and we can’t stock the hospital with medicine,” he said.

He called on relevant government agencies to launch investigations to find out whether NHIF had an ulterior motive when it stopped the hospital from offering services to students.