The Directorate of Criminal Investigations has launched investigations on NHIF after a directive by the courts to probe the accounts and invoices for the firm.
DCI is investigating how NHIF officials squandered up to Ksh12 billion from beneficiaries who have not sought medical treatment from any hospital.
Detectives had obtained a court order requiring the hospitals to produce books of account, invoices, and claims for payment by NHIF from 2013 to date.
According to documents, the DCI informed the court that it was investigating misappropriation of funds at the Fund and sought permission to search the hospitals and private residences of doctors.
Investigations revealed that rogue NHIF officials might have colluded with hospitals to generate false medical bills for workers who had never sought treatment.
Records indicate that NHIF received Ksh47.8 billion in contributions in 2017/2018 from medical covers for civil servants, Kenya Police Service, National Youth Service, and Kenya Prisons Service.
The detectives impounded special medical schemes worth Ksh12.7 billion annually, indicating that the government was double-charged due to a collusion between NHIF and hospital administrations.
The investigations also focused on healthcare providers and insurance brokerage firms that collect premiums, who are suspected to have inflated the premium collections.
DCI boss Geroge Kinoti confirmed that NHIF officials were under investigations for the fraud, terming it the cruelest he has ever encountered. He also noted that medical institutions have been lending a helping hand in the matter.
“This is the cruelest graft I have so far encountered. These merciless people have been stealing patients’ money, leaving them to die,” noted Kinoti.
The DCI set up a desk to handle the matter. Officials from the Office of the Director of Public Prosecutions (DPP) are also part of the probe team.
“We are talking to all those who played any role in this issue before we make our conclusions and recommendations. It doesn’t matter who they are,” he added.