Elijah Wachira, the acting CEO of the Social Health Authority (SHA), had been placed on forced leave for 90 days.
The SHA board, which took the decision, partially blamed him for the ongoing problematic transition from the National Health Insurance Fund (NHIF) to the authority.
The board appointed Robert Ingasira, Director of Financial Services, as acting CEO.
Wachira has denied all claims and stated that he is unaware of any diverted monies. Abdi Mohamed, chairman of the SHA board, did not immediately comment.
The board also accused Wachira of prioritising payments to private hospitals for services provided to SHA members over public hospitals.
The ousted CEO has denied all these accusations.
Wachira was appointed CEO of the NHIF in October of last year, following a competitive process.
“The new management team brings on board an invaluable wealth of experience that will immensely contribute to the transition of the Fund into success,” former NHIF Board chairman Michael Kamau said at that time.
According to a document seen by leaked.co.ke, Wachira has been placed on obligatory leave for three months.
“This is to inform you of the resolution of the board to send you on a compulsory leave effectively immediately to allow for further investigation into your professional conduct,” a letter by SHA chairperson Abdi Mohamed reads in part.
The letter goes on to say that while on leave, Wachira will be entitled to all of his income and benefits, and he has been directed to give over his office to Mr Ingasira forthwith.
He is a seasoned insurer, having served as Managing Director of CIC General for four years before joining NHIF.
Wachira is a seasoned insurer who previously served as Managing Director of CIC General for four years before joining NHIF.
According to the minutes from Tuesday’s meeting, the board complained about mounting pending bills, which have forced hospitals to ask patients to pay cash.
“As its first assignment towards UHC attainment, it has been critical to pursue the clearance of these pending bills as they also disburse claims on time to avoid payment backlogs,” the minutes read.
“Fifty percent of the Sh19 billion pending bills have been cleared in just over one month, a historic fete since the advent of SHA.”
“It therefore comes as a concern when the Acting CEO, Mr. Elijah Wachira takes actions that not only go against this effort but put the delivery of health care services at risk despite the government’s best effort by diverting resources to a tune of Sh1.6 billion earmarked for offsetting debt to public government facilities almost leading to paralysis of healthcare on account of pending bills,” the board said.
This is the second change in leadership for the nascent fund, which was established only two months ago.
The first was the removal of former chair Dr Timothy Olweny, just days before SHA’s launch.
According to a recent S research, private health institutions are filing more SHA claims, which is consistent with the previous NHIF pattern.Over the last month, SHA enlisted approximately 4,583 government-owned health facilities, 2,500 commercial facilities, and 548 faith-based organizations.
However, private facilities received the most service authorizations, with 85,700, compared to 78,100 for government facilities.Private facilities also made claims totaling Sh1.2 billion, while government facilities claimed Sh1.1 billion.
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