The National Health Insuarance Fund (NHIF) has been embroiled in a scandal after an audit revealed excess payments of Sh367 million due to “typing errors”.

According to the Auditor General Nancy Gathungu’s report, the NHIF paid out Sh814.9 million in claims, despite hospitals only billing Sh447.12 million through various schemes.

The NHIF attributed this Sh367.8 million variance to “typing errors” by hospital clerks, but could not provide any evidence of recovering the overpayments or reconciling the data.

The audit revealed that while the hospitals billed NHIF Sh447 million, the fund paid out Sh814 million – an unexplained excess of Sh367 million.

The excess payments were made across various NHIF schemes, including the National Police Service, NHC, UHC, civil servants, Edu Afya, county, parastatal, and Linda Mama programs.

The Sh367 million in excess payments is just a fraction of the concerning findings in Gathungu’s report. The auditor general flagged over Sh7.4 billion in unexplained NHIF expenditures for the year ending June 30, 2023.

Further analysis revealed Ksh2.9 billion in duplicate healthcare provider claims, with the same provider name but different outstanding amounts and hospital codes.

Additionally, Sh247 million in duplicate payments were made to the “same patient”.

The report also uncovered Sh51 million paid for a single patient admitted to multiple hospitals concurrently, as well as Sh47 million in unconfirmed benefits under the Linda Mama program, including Sh41 million for 10,860 duplicate normal delivery claims and Sh5.7 million for 656 duplicate caesarean section claims.

These findings raise serious concerns about accountability and oversight within the NHIF, as the government prepares to roll out the new Social Health Insurance Fund to replace it.

The extended rollout deadline and upcoming registration launch on July 1 will be closely watched amidst these revelations.