Nairobi Outpatient Centre sues NHIF over State staff cover

A private hospital wants the National Health Insurance Fund compelled to release over Sh31 million spent to treat about 10,000 members of the disciplined forces and civil servants.

Nairobi Outpatient Centre has sued the NHIF over a debt alleged to have accrued as a result of a health cover given to the officers and their dependants between 2013 and 2014.

“The payments were not made by the defendants as envisaged under the agreement. The NHIF refused to settle the debt of Sh31 million,” Mr Livingstone Karakacha, the general manager of the health facility, told the court.

PRIMARY HEALTHCARE

According to the health centre, the pair entered into an agreement with the fund in 2012 for the provision of primary healthcare and medical treatment services for 9,954 civil servants and their dependants.

Mr Karakacha said the payments were supposed to be made quarterly in advance.

The hospital claimed that it met its end of the bargain (offering medical services) but the NHIF has refused to honour its part.

Dr Mary Madumadu, who is in-charge of the cover at hospital, said the insurance fund had refused to release data of all those covered in a bid to conceal that they were actually given medical care.

She claimed that at other times the fund requested the health centre to provide medical care to its members who did not appear on the electronic data given to them.

The fund, however, dismissed the allegations, saying that the hospital continued to provide health services despite the expiry of a one-year contract between the two parties. The proceedings continue.