Tanzania: NHIF Warns Members Over Fake Claims

Mwanza — THE National Health Insurance Fund (NHIF) has warned some of its accredited health facilities against presenting fake claims, saying the malpractice poses serious challenge to the fund’s operations.

The fund said that although it has installed mechanism to track such health facilities, the misconduct should be stopped because it is against the laws governing the health scheme.

“NHIF won’t hesitate to take legal measures against any facility which will present fake claims, we normally operate in line with the laws and regulations which give us the mandate to act against any kind of fraud,” said NHIF Regional Manager, Mr Jarleth Mshashu at a one-day seminar for members of the workers’ unions in the region.

The workshop, which brought together 26 participants, including Tanzania Union of Government and Health Employees (TUGHE), Trade Union Congress of Tanzania (TUCTA) and Communication and Transport Workers Union of Tanzania (COTWU), aimed at building capacity to participants on various activities carried out by the fund.

NHIF Quality Control Officer, Dr Julieth Muhanika, said that most of the fake claims include additional charges especially on medical drugs.

“Some health facilities have no fixed prices for medicines thus we keep on educating our clients on the ways NHIF operates in line with existing rules and regulations as well as fund’s liability,” she said.

Acting Mwanza Regional Administrative Secretary, Mr John Magazeti, urged the workers to join the fund in order to reduce unnecessary medical expenses.

He also advised NHIF staffs to strengthening public awareness campaigns so as to allow all Tanzanians to access health insurance services.

Chairperson for Ilemela District Teachers Association, Mr Benjamin Bulugu, asked the NHIF to introduce funeral insurance services for its members.

In the past few years NHIF installed systems to control abuse of beneficiaries’ cards and check embezzlement.

According to the Fund, the systems bar beneficiaries from accessing similar services which they had received in one of the accredited health facilities unless it is an emergency.

It also said that the insurance scheme has continued to improve its systems to facilitate monitoring and fast-track the provision of services including payments for the service providers.

Improvement in Information and Communication Technology systems has helped members to access information through the mobile phone after accessing service.


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