December 2023, the Senate opened a probe into the loss of Sh176.1 billion allocated in the last nine years to medical schemes for teachers, police and prison officers.
At the centre of the probe was the Medical Administrators Kenya Limited (MAKL), a private company founded on the grounds of curbing medical billing fraud cases hence are the ones who pay hospitals where Teachers, police and prison officers’ insurances work.
The probe by the Senate was informed by frustrations teachers face including lack of access to medical services forcing them to dig deeper into their pockets to meet treatment expenses- the conmanship exposed our previous article how the system is intended to frustrate the insured.
This situation forced policy holders to seek alternative service in other hospitals despite the government having paid for their medical insurance cover.
MAKL and Bliss, are the capitation providers and administrators for the teachers, police and Kenya Prisons medical insurance-schemes.
“The Teachers Service Commission and the National Police Service Commission need to come before this House to explain the delays in processing of the medical insurance claims and payment to hospitals sub-contracted to MAKL,” said Nominated Senator Raphael Chimera.
He particularly wanted the Health Committee of the Senate to be provided with details of the medical insurance schemes for the teachers and police officers sub-contracted and managed by MAKL “indicating the number of respective beneficiaries and panels of medical and healthcare service providers.”
In response to this request, the Senate Clerk Jeremiah Nyegenye, separately did write to the TSC and NPSC seeking to find out how the medical insurance claims for teachers and police are processed respectively.
“The committee should therefore report on the criteria for processing claims at MAKL, explaining the delays reported by the teachers and the police officers in the processing of medical insurance claims and treatment in the MAKL contracted hospitals,” the letter seen by the Kenyan hour , reads in part.
9 months later, these turned out to had just been theatrics of oversight and as confirmed by a source that the Senate committee thirst were quenched to forgo the matter. They were bribed.
Jayesh Saini is a close associate to President William Ruto, Financier- a member of the deep state if you’d say.
KenyanHour 