BY SAM ALFAN.
The trial of former National Hospital Insurance Funds (NHIF) CEO Richard Kerich and others heard that medical provider Meridian Medical Centre was paid for non existence facilities.
Former Kericho NHIF branch manager Solomon Parendo told the trial magistrate that Meridian did not have a branch in Kericho when the service was rolled out.
Parendo was testifying in a case where Dr Kerich, Marwa Fadhili Chacha, David Chingi, Peter Ngunjiri Wambugu, Ndiba Wairioko and Meridian Medical Centre Limited are charged with conspiracy to defraud NHIF of over 116 million.
“There were no facilities relating to Meridian medical at the time the NHIF scheme was rolled out,” Parendo testified.
The scheme, (civil servants and Disciplined services medical scheme) which was rolled out in January 2012 involved accrediting hospitals to cover out patient services, more so civil servants and Disciplined forces.
However, according to the prosecution, the capitated health provider could could cover a member via referral to another hospital.
“Treatment can be done in a different NHIF accredited hospital and the capitated institution will be invoiced to pay the money, not go back to claim at NHIF,” Parendo testified.
Meridian was allegedly declared as a health provider to work with NHIF in 2009
The court further heard that there was no provision/obligation in the contracts between health providers and NHIF to have clinics all over the country.
Another witness, Vincent Magare was the NHIF quality assurance officer in Kakamega at the time, also testified that some patients complained that they were allocated health facilities they never chose including Meridian.
Magare stated that after receiving the the complains he directed them to the branch manager who ordered him to find out where Meridian is located.
“I came to know about Meridian after the complains since I was told to find out where it is located,” he said.
According to the officer, there was a signpost at the then Nakumatt building in Kakamega saying they were on first floor.
He told the court that he went there and found a lady who was examining a patient.
Magare testified that he tried to enquire from her about civil servants who visited their hospital but she told him to get in touch with the headquarter since she did not know such information.
The witness further told the court that he never inspected Meridian for accreditation during that time.
It was however, the defense statement that the scheme was treatment based and not branch based.
They are accused that on diverse dates between December 2011 and February 2012 at NHIF building in Nairobi conspired together to defraud the National Hospital Insurance Funds Kshs. 116,935,500 by entering into a contract under which Meridian Medical Centre Limited were to provide medical services under the civil services and disciplined forces scheme while knowing that the said Meridian had no capacity to provide such services.
Kerich and Chacha are also accused that on diverse dates between January, 2012 and February 2012 at NHIF building in Nairobi being persons charged with management of public service as chief executive officer and manager strategy and corporate planning with NHIF, jointly and willfully failed to comply with the law relating to procurement of services of the public procurement and disposal Act 2005in the procurement of Meridian Medical Centreas a service provider over civil servants and discipline services medical scheme.
Kerich , Chacha and Chingi are also accused of jointly using their offices to improperly confer benefit of Kshs. 43,498,125 to Meridian Medical Centre Limited by assigning members to the said Meridian under the civil servants and discipline services to medical scheme to nonexistent and accredited facilities thereby inflating the amount payable to the said medical centre.
Prosecution alleged that Peter Ngunjiri Wambugu , Ndiba Wairioko and Meridian Medical Centre Limited on or about the March 13,2012 in Nairobi being directors of Meridian Medical Centre obtained Kshs. 43,498,125 from NHIF by falsely pretending Meridian had capacity to provide medical services to civil servants and members of the discipline forces through out the country under the civil servants medical scheme a fact they knew to be false