MPs put Minet on the spot over Teachers’ Medical Insurance Scheme

𝐄𝐃𝐔𝐂𝐀𝐓𝐈𝐎𝐍 𝐂𝐎𝐌𝐌𝐈𝐓𝐓𝐄𝐄 𝐏𝐑𝐎𝐁𝐄𝐒 𝐒𝐄𝐑𝐕𝐈𝐂𝐄 𝐏𝐑𝐎𝐕𝐈𝐃𝐄𝐑 𝐎𝐕𝐄𝐑 𝐓𝐄𝐀𝐂𝐇𝐄𝐑𝐒’ 𝐌𝐄𝐃𝐈𝐂𝐀𝐋 𝐈𝐍𝐒𝐔𝐑𝐀𝐍𝐂𝐄 𝐀𝐌𝐈𝐃 𝐂𝐎𝐍𝐂𝐄𝐑𝐍𝐒 𝐎𝐅 𝐏𝐎𝐎𝐑 𝐒𝐄𝐑𝐕𝐈𝐂𝐄 𝐀𝐍𝐃 𝐃𝐄𝐋𝐀𝐘𝐒

The National Assembly Committee on Education has put medical service providers on the spot over persistent challenges in the Teachers’ Medical Insurance Scheme.

Appearing before the Committee were Mr. Parmanand Mishra, Chief Operating Officer of Medical Administrators Kenya Ltd (MAKL), Dr. Felix Wanjala, CEO of Bliss Healthcare, and Mr. James Njuguna, GM Operations at MAKL.

The consortium, led by Minet Kenya, was awarded the tender for the 2022-2025 period under a hybrid model that combines capitation and insurance. Other consortium members include Bliss GVS Healthcare, Medical Administrators Kenya Limited, Old Mutual, CIC, Britam, Pioneer Assurance, and Star Discover

The representatives faced questions from Members of Parliament keen on addressing the plight of teachers particularly the delays in treatment approvals, limited access to quality care in rural areas, and complaints over the use of low-quality medication.

Committee Chair, Hon. Julius Melly raised concerns about the scope of the scheme, which covers over 300,000 teachers and their dependents across Kenya. “As you are aware, the Teachers Service Commission (TSC) in Kenya has partnered with Aon Minet and Bliss Healthcare to offer a comprehensive healthcare package,” said Hon. Melly. “However, over the years, numerous challenges have emerged, affecting access and quality of healthcare for our educators.”

Committee Vice Chair, Hon. Eve Obara questioned the lengthy wait times reported by teachers seeking critical care. “What measures are in place to expedite the approval process for specialized and overseas treatments?” she asked.

In response, Bliss CEO, Dr. Wanjala explained that “all acute outpatient visits are handled directly without pre-authorization, and over 96% of inpatient admissions are approved within 30 to 45 minutes.” He added that emergency cases are attended to immediately and that providers are regularly trained to reduce documentation errors that delay approvals.

However, Committee Members expressed dissatisfaction, citing continued bottlenecks. Hon. Nabii Nabwera raised concerns about teachers in rural areas travelling long distances to access care. “Some of your facilities are very far from the teachers. What strategies are being implemented to decongest urban hospitals and improve rural access?” he asked.

Documents submitted to the Committee revealed that while Minet operates 47 facilities and Bliss runs 35, with the broader network comprising 763 accredited facilities. However the Committee noted that coverage rural areas remained inadequate.

Hon. Mary Emaase raised alarm over the alleged use of low-quality medication. “We’re receiving complaints about poor services and the use of low-quality generic drugs,” she noted, demanding stronger oversight and enforcement of medical standards.

The legislators also grilled the consortium over delayed payments to hospitals, with some providers reportedly turning away teachers due to unpaid bills. “What steps have been taken to ensure timely payments and how do you address cases of service denial?” asked Hon. Phylis Bartoo.

Mr. Mishra of MAKL assured the committee that reconciliation and payment timelines were being streamlined. “We are working closely with service providers to ensure prompt settlements and resolve any backlogs,” he said.

“Teachers need to be fully informed about their benefits and the procedures for accessing care,” said Hon. Julius Taitumu with Hon. Melly added that, “Our teachers deserve better, and we will hold each player accountable until they get the healthcare they are entitled to.”

Members noted that the consortium, led by Minet Kenya, was awarded the tender for the 2022-2025 period under a hybrid model that combines capitation and insurance. Other consortium members include Bliss GVS Healthcare, Medical Administrators Kenya Limited, Old Mutual, CIC, Britam, Pioneer Assurance, and Star Discover.

The Medical Administrators Kenya Ltd is expected to submitted a detailed reports on the status of its facilities before the Committee on Education within seven days.