NHIF sued over alleged Ksh.10M debt owed to nursing home


The NHIF building in Nairobi. Photo/FILE
The NHIF building in Nairobi. Photo/FILE

In Summary

  • The applicant was not given any materials or evidence that the respondents relied upon to reach the decision that it reached. The decision to terminate the applicants contract was administrative in nature was contrary to the constitution.
  • It is there argument that they were not given a reason statement of the said decision neither were they allowed to cross examine or rebut any allegations that the respondents levelled against it.
  • They claim that NHIF has accused them of unfounded allegations that would cause irreparable injury to them as a reputable health facility and loss unquantifiable measure.

The National Hospital Insurance Fund (NHIF) has been sued for allegedly not paying Ksh.10million to one of its service providers.

The applicants in the case, Patanisho Maternity and Nursing Home, claim that having provided services from 2015 to date, NHIF has refused to pay for the services to the tune of Ksh.10million.

The hospital argue that they entered in to a contract agreement from the provision of Comprehensive Medical Care and Treatment Services to Civil servants and Disciplined Services to both inpatient and outpatient.

Similarly they claim that despite the contract NHIF has unilaterally and without any prior notice terminated the provision of the said services.

According to the court papers, the decision to terminate the provision of services is allegedly based on an audit carried out by the respondents. They claim that the audit was done without prior, knowledge, participation or their representations

“The consequences is that NHIF decision will not only cause untold financial losses to the applicant but also expose the patients admitted and those who receive health services at the applicants facility harm since they will be left hopeless without any alternative access to healthcare, ”reads court documents .

The applicant was not given any materials or evidence that the respondents relied upon to reach the decision that it reached. The decision to terminate the applicants contract was administrative in nature was contrary to the constitution.

It is there argument that they were not given a reason statement of the said decision neither were they allowed to cross examine or rebut any allegations that the respondents levelled against it.

They claim that NHIF has accused them of unfounded allegations that would cause irreparable injury to them as a reputable health facility and loss unquantifiable measure.

The hospital now want the decision by NHIF to terminate the provisions of services be quashed on grounds that it had a legitimate expectation that it would continue providing health services until the end of the contract -2021.

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Story By Dzuya Walter
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