alexa Did NHIF trade in money meant to save mothers? - Daily Nation

Did NHIF trade in money meant to save mothers?

Tuesday November 27 2018

National Hospital Insurance Fund

National Hospital Insurance Fund CEO Geoffrey Gitau Mwangi (right) and the insurer’s chief finance director Wilbert Kiplangat Kurgat at a Milimani court in Nairobi on November 26, 2018, where they were charged with obstructing justice. PHOTO | DENNIS ONSONGO | NATION MEDIA GROUP 

MAUREEN KAKAH
By MAUREEN KAKAH
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BRIAN WASUNA
By BRIAN WASUNA
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Mr Geoffrey Mwangi, the chief executive officer of the National Health Insurance Fund, is a man in trouble.

If detectives prove their claim that, under his watch, money intended to cover expectant mothers under the Linda Mama programme was used for trading in opaque circumstances, he may well become quite unpopular too.

During Labour Day celebrations last year, Cotu secretary-general Francis Atwoli praised Mr Mwangi, in the presence of President Uhuru Kenyatta, as the right person to lead NHIF.

When the Nation asked Mr Mwangi two months later why he was the right man to lead the social health insurer, he counted in his favour his experience of more than 20 years at the Fund, his alleged commitment to transforming lives for the better, and a claimed focus on getting quality healthcare to all NHIF members.

DIVERGENT VIEW

Detectives are taking a decidedly divergent view, and so does Mr Atwoli, who has made an about-turn and called out NHIF and NSSF.

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When Mr Atwoli, who represents workers in the boards of the two Funds, called for investigations, it marked a turning point in the relationship between the two.

At the time, up to Sh6 billion was said to have been misappropriated at NHIF, with some executives engaged in grand real estate developments in Nairobi’s more expensive suburbs. When the Directorate of Criminal Investigations followed on Mr Atwoli’s leads, their curiosity was deepened by apparent stonewalling on the investigations by Mr Mwangi.

According to SMS evidence retrieved from his phone, Mr Mwangi instructed the NHIF Finance Director Francis Kurgat not to release “the air rescue thing and all the things I had given” to detectives.

DOCUMENTS

“Do not give them. Tell them you are looking for them … they give you time. And they need to inform me. Actually, tell them they took them,” Mr Mwangi instructed on Wednesday, November 21, 2018.

The instructions appeared to mark a change of heart on co-operating with investigators, as on November 12, 2018 Mr Mwangi had instructed Mr Kurgat to make sure the documents were ready for him to sign when he returned from Nyeri.

Prosecutors believe the “things” in question refer to payment vouchers that they believe will unearth a money siphoning scheme at NHIF, through Webtribe Limited, a software development firm that trades as JamboPay.

According to detectives and prosecutors, there are as many as 10 scandals at NHIF, and they represent what they describe as the most noxious corruption that has led to the loss of billions of shillings.

JAMBOPAY

In the case of JamboPay, NHIF advertised and intended to procure a software to facilitate payments, detectives claim. In the end, it ended up mysteriously hiring the same software for Sh490 million and paying commissions of Sh911 million.

Then there is the question of capitation, where detectives are investigating claims that corrupt fund officials have been fraudulently transferring patients to fake hospitals. For example, if Mbagathi Hospital has 1,000 patients, officials clone the details of 700 patients and pretend that those patients are receiving treatment at a Mickey Mouse private hospital which has no capacity to give such treatment. The Mickey Mouse hospital is paid, the loot is shared with fund officials, and Mbagathi is left endlessly pursuing arrears.

Another alleged scheme is outright theft, detectives say, where, for example, a hospital claims Sh1.5 million but is paid Sh150 million and the difference is split with the corrupt Fund officials.

TREATMENT

Also being investigated is the overseas treatment scheme, which detectives claim has been used to siphon money from the Fund. Not to mention that the Fund is also being accused of using Corporate Social Responsibility funds to contribute to harambees.

However, none of these claims have been proven in court, and no officials have been charged with any offences. They are, by law, innocent until otherwise pronounced by a court.

It is not clear what prompted Mr Mwangi to take two extreme positions on the investigations. However, they mark the mysterious profile of a man who was appointed in February 2016 as the CEO of the then Sh13 billion NHIF when he was in his mid-30s.

Little is known of the man who some trace as the son of a cartographer in Nakuru. In the NHIF annual report for the year ended June 30, 2016, he is described as a specialist in behavioural finance.

RESTRUCTURING

Mr Mwangi was strategically positioned to rise to the helm of the NHIF when, in 2015, management firm Deloitte recommended a thorough restructuring of the insurer to enable the Fund meet its mandate of serving more members.

The changes were also meant to help it manage contributions, which soon more than doubled, from Sh12.4 billion to Sh28.4 billion in 2016 after the law was changed to allow member remittances to be based on income.

In its strategic plan, NHIF expected contributions from members to grow from 36.6 billion to Sh40.3 billion, with a membership of seven million.

Deloitte recommended that the seven general managers be replaced by four directors. Of the seven, only Mr Mwangi made it past the interview, becoming the first among equals in the institution by virtue of his long stay.

COMPLEX TRANSITION

Since his appointment, he oversaw a complex transition to universal healthcare — where contributors and their dependants pick mother hospitals for out-patient services on top of the traditional in-patient rebates. He also introduced funding for cancer treatment and surgery overseas for up to Sh500,000 for services not available locally.

He attracted controversy in equal measure, such as in early this year, when NHIF sought to limit beneficiaries to one treatment per quarter in a bid to control claims. That suggested the Fund had spread itself too thinly as qualifying facilities adopted a dual pricing structure — a normal one for out-of-pocket payers and those with private insurance covers, and an inflated one for those holding the NHIF card. Analysts pointed out that such grand theft could not have gone on without collusion from NHIF insiders.

DEFEAT JUSTICE

On Monday, prosecutors argued that the text messages were evidence that there was a conspiracy to stop ongoing investigations into the health insurer and urged the court to deny the two bond.

According to the charge sheet, the duo is accused of conspiring to defeat justice between September 26 and November 23 by failing to comply with a court order requiring them to produce any books required by detectives for scrutiny.

They also face two counts of disobeying a lawful order at the NHIF offices based in Nairobi’s Upper Hill on November 21.