Kenya, Feb. 12 -- Jayesh Saini is a well-known person in Kenya's healthcare field, and he is currently under investigation because of his work with the Social Health Authority (SHA) and various health insurance plans.

Saini is associated with companies like Bliss Healthcare, Medical Administrator K Limited, and LifeCare Hospitals, but he is facing issues related to money mismanagement in health insurance.

He is at the centre of the Sh 55 billion teachers' medical insurance controversy that was blasted recently after some hospitals withdrew their services to beneficiaries and families due to arrears amounting to billions.

There has been a lot of talk on social media connecting Jayesh Saini to problems with medical insurance for teachers.

Many teachers and other civil servants are upset because they are not receiving good services, even though money is taken from their salaries for health coverage.

However, there are many complaints from contributors about not getting services under these insurance plans. This situation raises doubts about whether these contracts are working well and if they are honest.

The SHA also mentioned that it is having money problems that are hurting its operations. The Medical Services Principal Secretary, Harry Kimtai, told the National Assembly Committee on Health that SHA is still dealing with debts from the old National Hospital Insurance Fund (NHIF) scheme since it started in October 2024.

When talking to the committee led by MP Robert Pukose on February 10, Kimtai said that NHIF still owes health care providers about KSh 30.9 billion.

He also mentioned that different government departments owe SHA around KSh 25 billion, which could help pay the debt to hospitals.

"The defunct NHIF owes healthcare providers an estimated KSh 30.9 billion. SHA has been working with various ministries and departments to collect KSh 25 billion in unpaid debts to NHIF to help pay outstanding bills," Kimtai explained.

He noted that SHA is facing money problems because many registered members are not paying their monthly fees. Out of over 18 million Kenyans registered, only 4 million are currently paying.

"This low participation shows that many registered people are not involved. The issue is particularly big in the informal sector, which has a lot of people with unstable incomes," Kimtai added.

However, MP Pukose challenged SHA to explain how they spent the money they received in the last budget. Reports indicated that SHA had spent only KSh 375 million out of KSh 4 billion received from the government.

"Parliament has given you KSh 4 billion, but you have spent only KSh 375 million so far. You also received KSh 2 billion but spent just KSh 21 million. This means you have enough money to pay hospitals for Kenyan patients," Pukose said.

The acting CEO of SHA, Robert Ingasira, stated that SHA has had to limit funding to only a few urgent cases, like emergency care. These emergency services remain free for the first 24 hours.

"We provide urgent care, stabilisation, and resuscitation for emergencies, but only within the first 24 hours," Ingasira explained.

In January 2025, President William Ruto's government acknowledged the difficulties facing its Taifacare program under the SHA.

Published by HT Digital Content Services with permission from Bana Kenya.