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{
    "id": 1401007,
    "url": "https://info.mzalendo.com/api/v0.1/hansard/entries/1401007/?format=api",
    "text_counter": 168,
    "type": "speech",
    "speaker_name": "Hon. Nakhumicha",
    "speaker_title": "The Cabinet Secretary for Health",
    "speaker": {
        "id": 520,
        "legal_name": "Reginalda Nakhumicha Wanyonyi",
        "slug": "reginalda-nakhumicha-wanyonyi"
    },
    "content": " Thank you, Mr. Deputy Speaker, Sir, and Members. The question was that I confirm that there is widespread medical insurance fraud that is perpetuated by health facilities in Kenya, particularly within the private health sector, through practices such as unnecessary medical tests, scans and incorrect diagnoses aimed at unfairly generating revenue for facilities. The issue of medical insurance fraud committed by health facilities in Kenya, including the private sector, is a serious concern that has received attention from the Ministry of Health regulatory authorities and enforcement agencies. There have been reported cases of facilities engaging in fraudulent practices to unfairly generate revenue, such as impersonations, raising fake claims for patients who never received any service, ordering unnecessary tests or procedures, providing incorrect diagnoses and inflating bills submitted to insurance providers. These fraudulent activities not only harm patients by subjecting them to unnecessary medical interventions, but also lead to financial losses for insurance companies and undermine the integrity of the healthcare systems. Consequently, the MoH, the National Health Insurance Fund (NHIF) and the Kenya Medical Practitioners and Dentists Council (KMPDC) have taken action to address these issues, including suspending facilities found guilty of engaging in fraudulent practices. Mr. Deputy Speaker, Sir, currently, the prevalence of medical fraud as per external actuarial analysis stands at 20 per cent. It is important for stakeholders, including insurance providers, regulatory bodies, investigative bodies and law enforcement agencies to collaborate and identify investigating and prosecuting individuals and facilities involved in insurance fraud. By enforcing strict regulations, conducting thorough audits and promoting transparency and accountability in health care delivery, we can collectively work towards combating fraudulent activities and safeguarding the interests of patients and insurance beneficiaries. The electronic version of the Senate Hansard Report is for information purposesonly. A certified version of this Report can be obtained from the Director, Hansard and AudioServices, Senate."
}