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Teachers health scheme in disarray over fraud

by The Informer
May 8, 2017
in News
Reading Time: 2min read
Teachers health scheme in disarray over fraud
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Provision of health services to teachers has been thrown into disarray after AON, an administrator of teachers health scheme terminated, suspended and warned a total of 30 hospitals over alleged fraud and poor services.

In a move likely to disrupt provision of healthcare services, five hospitals were struck out from the panel of service providers while four others were suspended indefinitely and twenty one others received warning notices.

Specifically, those affected are teachers under the membership of Kenya Union of Post Primary Education Teachers (Kuppet).

According to correspondence obtained by The Informer, AON director of Managed Medical Care Dr Njoki Fernandes the affected facilities have verified cases of fraud and consistent poor services.

“To assist us fulfill our promise of excellent service delivery to you, we wish to inform you of the termination of certain service providers from our panel of service providers. This is due to verified cases of fraud and consistent poor services to our customers.”

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The letter reference number Our Ref:MMC/KUPPET/HQ/SP/0704/ac reads in part.   Njoki sent the letter to Kuppet Secretary General Akello Misori on April 12, 2017. Akello office received the notification on April 26, 2017.

Sofiaz Hospital, Kerugoya Medical Centre, Mashallah Nursing Home, Ismc Medical Centre and Griftu Nursing Home were terminated permanently.

On the other hand, Neno Opticians, Sigmart Opticals, Crystal Optics and International Optica were suspended indefinitely.

Although AON said they have replaced all the affected health facilities with others in the same or nearby localities, they are yet to issue a breakdown of the hospitals enlisted in the new panel of medical providers where teachers should seek medical services.

Among the 21 hospitals warned over alleged fraud and poor services include; Gertrudes Childrens Hospital Muthaiga, Radiant Group of Hospitals, Afya Nursing Home, Diani Beach Hospital, Eldoret Hospital, Ladnan Hospital, Meridian Medical Centre Malindi and Limuru Cottage among others.

Others are Bristolpark Hospital, Bungoma West medical Services, County Medicare Ltd, Embu Childrens Hospital, Kitengela Medical Services Kajiado, Liberty Maternity and Nursing Home, Mashallah Nursing, Meru Jordan Hospital, Mikindani Medical Centre, Mikulinzi Nursing Home, Naidu Hospital and Jocham Hospital.

Teachers were herded into the new scheme, though not voluntarily with provision of comprehensive in-patient and out-patient services in all hospitals across the country.    Police officers also want the scheme administered by the embattled AON Minet terminated.

They have severally complained at police headquarters, Vigilance House and to the Directorate of Criminal Investigations after being turned away or detained in hospitals since their identities are not in the database provided by the scheme administrator.

Among the hardest hit are police and prison officers in remote areas.   The controversial scheme was launched on October last year after the government procured a comprehensive medical Insurance cover for all National Police and Kenya Prisons Service officers.    All officers covered by National Hospital Insurance Fund (NHIF) scheme were migrated to the new i

nsurance scheme- AAR Consortium, effective from October 1, 2016.   Cases of insurance fraud are on the rise involving a network of cartel and rogue practitioners in the medical and insurance industries.

The Informer

Tags: Bristolpark HospitalBungoma West medical ServicesCounty Medicare LtdEmbu Childrens HospitalKitengela Medical Services KajiadoLiberty Maternity and Nursing HomeMashallah NursingMeru Jordan HospitalMikindani Medical CentreMikulinzi Nursing HomeNaidu Hospital and Jocham Hospital
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