Why Teachers will now be forced to pay for Medical Services out of Pocket: A shortfall exceeding Sh11 billion in medical insurance funds has compelled teachers, police officers, and prison staff to resort to cash payments for medical services.
MAKL owes hospitals Sh11.6 billion
Hospitals are yet to receive Sh11.6 billion owed to them by Medical Administrator Kenya Limited (MAKL) since April last year. MAKL oversees health insurance schemes for Kenyan teachers, law enforcement personnel, and prison guards.
The medical scheme for teachers has accumulated arrears of Sh7.6 billion. The one for the police owes up to Sh4 billion. This is quite unfortunate, given that teachers pay for two different medical schemes. They forfeited their medical allowance for the AON (Minet) medical scheme. Besides that, TSC deducts them monthly for the NHIF statutory medical scheme.
National Treasury has failed to remit funds consistently
In a letter sent to hospitals on April 9, MAKL acknowledged the outstanding debt. They attributed the delay to tardy disbursements from the National Treasury.
The letter reiterated MAKL’s commitment to settling dues promptly upon receiving expected funds from the national government.
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“We have made efforts to resolve this administrative challenge. We therefore request patience and understanding from all the stakeholders,” said the MAKL letter.
MAKL expressed appreciation for the ongoing collaboration and emphasized the importance of regularizing payments.
Treasury has not remitted money for many months
Treasury has not made disbursements for the medical schemes of teachers and security personnel in seven months. The last time the government remitted some money was September 2023.
MAKL transfers funds allocated to hospitals through the National Police Service Commission (NPSC) and the Teachers Service Commission (TSC).
The route involves the Ministry of Education, Treasury, TSC, Minet, and MAKL for teachers. As for the police funds, they pass through NPSC, APA/Minet, and MAKL.
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Many teachers don’t like the medical scheme that the government imposed on them. Despite teachers’ preference for coverage under the National Health Insurance Fund, TSC awarded Minet a three-year contract in November 2022. The contract will end in November 2025 when TSC will advertise the tender again.
Recently, MAKL announced the appointment of APA Insurance as the principal insurer for the Sh8.67 billion police and prison officers’ insurance plan. This effectively replaced CIC. The police were not happy with this decision.
Why police and prison officers are opposed to the medical scheme
The major reasons for their dissatisfaction include claim rejections and delays in processing. Hospitals have also accused MAKL of causing delays in claims processing.
Last year, the Senate initiated an investigation into the disappearance of Sh176.1 billion allocated for the three medical schemes. The investigation was prompted by teachers’ frustrations and constant complaints.
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On top of non-remittance of the medical schemes’ money, the government has had challenges updating statutory deductions. For instance, Treasury only managed to repay Sh4.59 billion to the Public Service Superannuation Scheme. It failed to remit these funds between May and June 2023, according to Margaret Nyakang’o, the Controller of Budget.
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