Teachers, police and Prison Officers will be forced to cater for their own medical bills due to teachers police insurance claims pushing the tussle between the insurer and the hospitals escalate.
This comes after the hospitals hired to treat teachers and the police under the multi-billion government sponsored medical insurance scheme threatened to withdraw their services over a Ksh. 5 Billion unpaid capitation claim.
However, according to reports, the government released funds for both teachers and the police through their respective commisions. For instance, Ksh. 17.6B was released to the Teacher’s Service Commission (TSC) for medical insurance for teachers in public schools.
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In addition, Ksh. 13.6B was released to the National Police Service Commission (NPSC) to cater for both the police officers and those from Kenya Prisons for the medical cover.
The claim comes after the Senate and the National Assembly started investigating the legality of Medical Administration Kenya Limited (MAKL) that has according to reports delayed the release of the accrued capitations to hospitals.
Nairobi West Hospital is among the health facilities that are owed by the Medical Administration Kenya Limited and has written to them to demand payments of funds totaling to Ksh. 576.79M. The letter was alco copied to the Inspector General of Police and Kenya Prisons Service commissioner.
“Please note that failure to fulfil your contractual obligations on payments has led to constraints in the hospital’s operations including but not limited to inability to pay our doctors, service providers and suppliers. This has negatively impacted our procurement of medicine and other consumables.”
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The hospital has now threatened to suspend medical services under the insurance scheme until the ammount is paid by MAKL. This will see the Police, prison officers and teachers dig to their pockets for their own medical emergencies.
As the tussle continues, it is believed that MAKL frustrates both hospitals and those insured under them in a bid to make more profits. This is whereby, MAKL starts negotiating with hospitals to provide medical services at a lower cost to maximise profits. While hospitals also want to make profits from MAKL thus frustrating the patient. Teachers Police insurance claims that even emergency services take days to be tended to.
Hospitals contracted by MAKL then deny services in a bid to force profits from MAKL. This will have patients waiting for hours before being attended to in a bod to push them to pay their own cash for the medical services.