RUPHA Raises Alarm Over Reinstatement of Suspended Hospitals in SHA System
The Rural and Urban Private Hospitals Association of Kenya (RUPHA) has raised the red flag over what it terms as a major lapse in the Social Health Authority (SHA) system.
According to the lobby, hospitals that had been suspended from the SHA portal due to fraud-related investigations and compliance breaches were quietly re-activated in the last 24 hours.
In a statement issued yesterday, RUPHA said the sudden reactivation was due to a system glitch.
“Over the last 24 hours, all facilities that had been suspended from accessing the SHA portal due to either fraud investigations or compliance issues have had their access to the portal reactivated due to a bug in the SHA system,” the association said.
The group warned that such lapses could compromise patient safety and derail government efforts to crack down on fraud in the health sector.
SHA Yet to Respond
By the time of going to press, SHA had not responded to the claims. Efforts to get a comment were unsuccessful as representatives said they needed more time to look into the matter.
This is the latest in a series of concerns about SHA management especially after the transition from the defunct National Health Insurance Fund (NHIF). Patients and hospitals have raised issues ranging from delayed payments to claims of hospitals billing for services not rendered.
Healthcare Fraud on the Rise
Healthcare fraud is a global problem. In August, the Ministry of Health said it accounts for 15 per cent of global health expenditure.
Health Cabinet Secretary Aden Duale announced that the ongoing crackdown had led to the closure of 728 non-compliant facilities and downgrading of 301 others by the Kenya Medical Practitioners and Dentists Council (KMPDC).
He also revealed that investigations had uncovered widespread malpractice including falsified medical records, converting outpatient visits into inpatient admissions and phantom billing for patients who never existed.
In June, SHA suspended 40 facilities after forensic audits and said 45 others were under review for possible de-registration.
Scrutiny Intensifies
The fresh claims from RUPHA will now raise more questions on the SHA system as it continues to face transition challenges. The association has asked authorities to fix the system flaws to prevent hospitals under investigation from exploiting the loopholes to re-enter the scheme.
This will add to the public debate especially after Kenyans last month were outraged over reports of fraudulent facilities siphoning funds meant for service delivery.
Also Read: Major Twist: American Trucking Company Issues Strong Statement on Kenya–Nebraska Job Deal
RUPHA Raises Alarm Over Reinstatement of Suspended Hospitals in SHA System