Insurers reject Nairobi Women’s Hospital bills over ‘cost inflation’ claims

The Nairobi Women’s Hospital. FILE PHOTO | NMG 

By NASIBO KABALE
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Summary

• Mr Tom Gichuhi, the Association of Kenya Insurers (AKI) chief executive said that the underwriters held a meeting on Monday evening and resolved to take the drastic measure.
• The news comes after the hospital’s board of directors issued a statement saying it had commenced an internal investigation into claims that its doctors force patients to undertake unnecessary procedures.
• The board said it was also cooperating with the Kenya Medical Practitioners and Dentist Council, which is also conducting an independent investigation.

Health insurers will not honour future bills from the Nairobi Women’s Hospital, officials said on Tuesday, in a move likely to worsen the woes of the facility currently fighting claims of cost inflation.

Mr Tom Gichuhi, the Association of Kenya Insurers (AKI) chief executive said that the underwriters held a meeting on Monday evening and resolved to take the drastic measure.

“Medical insurance underwriters met and resolved not to deal with the facility in future. By Tuesday it had not been actualised, but I am certain that it will happen,” he said. A communication manager in at aninsurance firm who wished to remain anonymous said that patients currently admitted at the hospital would not be affected.

The news comes after the hospital’s board of directors issued a statement saying it had commenced an internal investigation into claims that its doctors force patients to undertake unnecessary procedures.

The board said it was also cooperating with the Kenya Medical Practitioners and Dentist Council, which is also conducting an independent investigation.

“We have noted with a lot of concern reports appearing in various media platforms suggesting that there is some systematic approach by the hospital to unfairly generate revenue from patients.

“Although we don’t believe this is the case, and in fact it is antithetical to our foundational principles, we take these allegations very seriously and are conducting an internal review as well as cooperating with the Kenya Medical Practitioners and Dentist Council as they carry out their independent review.”

The medical council CEO, Dr Eva Njenga said that they would reveal their findings within a month.

Leaked WhatApp chats appear to show how the hospital bosses set daily targets for the number of patients who should be admitted. They show that the revenue, commissions, admissions and discharge numbers were allegedly being actively monitored hourly, every day, and day and night by chief executive officer, Dr Felix Wanjala.

To do this, the CEO recommended that his team, based at the Nairobi Women’s Hospital branch in Nakuru (called Nakuru Hyrax) should “start with looking for referrals”, not miss “any opportunity (to admit)”, and be “very vigilant in casualty”.