Did Jayesh Saini Owner of Bliss, Nairobi west hospital, MAKL bribe Senate Committee in the lost Sh176 billion?

Jayesh – December last year 2023, the Senate opened a probe into the loss of Sh176.1 billion allocated in the last nine years to medical schemes for teachers, police and prison officers.

At the Centre of the probe was the Medical Administrators Kenya Limited (MAKL), a private company founded on the grounds of curbing medical billing fraud cases hence are the ones who pay hospitals where Teachers, police and prison officers’ insurances work.

The probe by the Senate was informed by frustrations teachers face including lack of access to medical services forcing them to dig deeper into their pockets to meet treatment expenses- the conmanship exposed our previous article how the system is intended to frustrate the insured.

This situation forced policy holders to seek alternative service in other hospitals despite the government having paid for their medical insurance cover.

MAKL and Bliss, are the capitation providers and administrators for the teachers, police and Kenya Prisons medical insurance-schemes.

“The Teachers Service Commission and the National Police Service Commission need to come before this House to explain the delays in processing of the medical insurance claims and payment to hospitals sub-contracted to MAKL,” said Nominated Senator Raphael Chimera.

He particularly wanted the Health Committee of the Senate to be provided with details of the medical insurance schemes for the teachers and police officers sub-contracted and managed by MAKL “indicating the number of respective beneficiaries and panels of medical and healthcare service providers.”

In response to this request, the Senate Clerk Jeremiah Nyegenye, separately did write to the TSC and NPSC seeking to find out how the medical insurance claims for teachers and police are processed respectively.

“The committee should therefore report on the criteria for processing claims at MAKL, explaining the delays reported by the teachers and the police officers in the processing of medical insurance claims and treatment in the MAKL contracted hospitals,” the letter seen by the Kenya-today.com , reads in part.

9 months later, these turned out to had just been theatrics of oversight and as confirmed by a source that the Senate committee thirst were quenched to forgo the matter. They were bribed.

Jayesh Saini is a close associate to President William Ruto, Financier- a member of the deep state if you’d say.

How Nairobi West Hospital and Bliss medical Owner Jayesh Saini Uses his company MAKL to Frustrate Teachers, Police Officers To Pay From own pockets.

The teachers’ medical service scheme, which has now become a source of numerous complaints over poor services, has run for 10 years.

Who is Jayesh Saini?

• Was the mastermind of Clinix scandal in Kenya’s healthcare history that stumbled NHIF
• Was the mastermind behind the illegal importation of Sputnik-V covid19 vaccine from Russia.
• TSC-AON Minet scandal mastermind

Jayesh-sputnik- Nairobi west hospital link

A botched deal to supply 1 million Sputnik V doses to Kenya was part of the same controversial Emirati scheme which saw an Abu Dhabi-based company with royal connections ink deals to resell Russia’s flagship covid vaccine at huge mark-ups.
Documents obtained by The Moscow Times confirmed that Russia named Aurugulf Health Investments – a firm registered in the UAE and linked to Emirati royalty – as an official Sputnik V reseller in Kenya, where it secured a contract with private healthcare company Dinlas Pharma to ship at least 1 million jabs to the African country.

Dinlas Pharma also paid significantly more than Russia’s advertised price for Sputnik V to obtain the jabs via Aurugulf. According to a pricing schedule obtained by The Moscow Times, Dinlas paid $18.50 a dose for the vaccines — almost twice Russia’s factory price of $9.95 – and planned to sell them to clients in Kenya for $42 each.
This shows the deep political ties this guy has On top of his well orchestrated game, he is the bulldoser clearly, he as well owns Medical Administration Kenya Ltd (MAKL) thru’ proxies —responsible for sorting out insurance claims for private hospitals.

How MAKL Intentionally Frustrate the insured-Teachers, Police officers, Prison officers.

For the record, MAKL is a private company and that the procurement of insurance for TSC is disguised as an insurance scheme.

The scheme tendering entity for TSC is Minet Kenya and for police is a consortium of insurance companies led by CIC General Insurance Limited.

The two insurance companies then contracted MAKL which charges up to 7 percent in administration fees to the tender amount as capitation administrator.

Business Standard highlights a momentous achievement! Jayesh Saini, Chairman of Lifecare Hospitals, has distinguished as the 'Best Emerging Leader 2023. This title underscores his leadership and innovative contributions to the healthcare sector.
Read more: https://t.co/rJ8jUaH8qf pic.twitter.com/TCZSsocoPf

— LifeCare Hospitals (@LifeCareKenya) November 23, 2023

The premiums as provided by the government are paid directly by the procuring entities- TSC, NPSC- to Minet Kenya and CIC General Insurance Limited.

The funds are then channeled by the insurance companies to MAKL for capitation purposes, which then empanels hospitals and doctors that are then tied up as a network of hospitals to provide services for the scheme.

The suffering of the insured under the schemes starts when MAKL, which retains all the rights for admission, negotiates with hospitals to provide the services usually at very low capitation fees for patients as it aims to maximise profits over service delivery.

The hospitals also need to make profits from the low capitation fees from MAKL.

In the end the hospitals contracted by MAKL maximise profits by way of either outright denial of services or endless frustrations like being kept waiting for hours so that patients give up and opt to pay for treatment from their pockets in other health facilities or in the very same facilities which are owned by Jayesh Saini; Nairobi West hospital, Bliss medical.

For example, surgery, which requires immediate medical intervention, takes days “until one gives up for out-of-pocket financing elsewhere or dies while still waiting to be treated.”

The fewer the patients a hospital under MAKL treats, the more money it makes from the capitation fees.

MAKL and Bliss are the capitation providers and administrators for the teachers, police and prison medical insurance schemes. In the current financial year, the premium allocated by the government to the TSC for the teachers’ medical insurance cover is Sh17.9 billion, meaning that for the past nine years it has been in operation, Sh161.1 billion is what the government has paid for the teachers’ scheme.

Exposed: Jayesh Saini behind Sputnik Vaccine, NHIF and TSC insurance scandals https://t.co/j5iF9FjEyy @naiwesthospital @nhifkenya @AARInsuranceU @_tsckenya #amerix #KenyaVsUK #marriage #stopkillingmen #kalonzo #magufuli #abrahamkiptanui#kenyatta Ruth chepngetich

— kenya breaking (@kenyabreaking3) April 4, 2021

The police and prison officers, on the other hand, have spent Sh15 billion on their medical scheme. What has concerned the Senate is that MAKL is a private company and that the procurement of insurance for TSC is disguised as an insurance scheme.

So, when Nairobi west hospital plays victim of being owed by MAKL and forces Teachers and Police officers to pay from own pockets, know the trick. It’s business and it is their business to maximize cash profit, capitation over service delivery.