Auditor General, Nancy Gathungu, has unearthed yet another shocking scandal at the National Health Insurance Fund (NHIF) running into millions of shillings.

The audit reveals billions of shillings in potential mismanagement, raising concerns about the Fund's ability to deliver essential healthcare services to Kenyans.

According to the report, in the year ending June 30, 2023, the NHIF inexplicably paid out Sh368 million more than it was billed by hospitals.

The Fund attributed this staggering discrepancy to mere "typing errors" by hospital clerks.

However, Gathungu's audit found no evidence to support this claim, nor did it reveal any attempts by the NHIF to recover the excess funds or reconcile data with hospitals.

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The Linda Mama program, a flagship initiative providing free childbirth care for all women in Kenya, appeared particularly vulnerable to abuse.

The audit identified a potential Sh54.5 million in excess payments related to the program, including instances of patients billed multiple times for the same caesarean section or normal delivery.

"The amount includes an amount of Sh5,713,000 paid to NHIF accredited hospitals whose analysis revealed 656 duplicate case code (01) on caesarean section deliveries procedures carried out on the same patient.," Gathungu's report stated.

"Similarly, the amount includes a balance of Sh41,332,700 whose analysis revealed 10,860 duplicated case code (02) on normal deliveries on the same patient."

The National Health Scheme (NHS) also showed signs of mismanagement.

Here, the NHIF inexplicably paid Sh205.9 million more than hospitals billed. The audit offered no explanation for this discrepancy.

Further compounding the problems, the audit uncovered Sh2.9 billion in outstanding debts owed to healthcare providers, with a significant portion containing duplicated healthcare providers with the same name but different outstanding amounts and different hospital codes.

This raises serious questions about the NHIF's internal controls and its ability to track payments accurately.

These irregularities are just the tip of the iceberg as Gathungu's report also highlights instances where hospitals submitted claims years after the designated 30-day window, potentially obstructing timely reimbursements and impacting patient care.

This scandal underscores the urgent need for a thorough investigation into the NHIF's management practices.

Kenyans deserve a healthcare system that is efficient, transparent, and accountable.

While the NHIF struggles with internal controls, it's the patients who ultimately suffer from denied services and a potential decline in the quality of care.