How Jayesh Saini Exploits MAKL (Medical Administrators (K) Limited) To Force Teachers And Police Officers Into Out-of-Pocket Payments At Nairobi West Hospital And Bliss Medical.
According to sources, a top politician in Rift Valley had to frustrate Mediheal Hospital until it was auctioned.
Jayesh Saini has become a notorious figure in Kenya, known for his involvement in multiple scandals that have rocked the country’s healthcare system.
His name has been linked to several controversies, including the Clinix scandal, the illegal importation of the Sputnik V COVID-19 vaccine, and the mismanagement of key medical insurance schemes in Kenya.
One of the most notable controversies involving Saini is the Clinix scandal.
This scandal involved the National Hospital Insurance Fund (NHIF), where Clinix Healthcare, a company associated with Saini, was accused of syphoning millions of shillings.
The funds were meant to provide healthcare services to civil servants but were instead allegedly funnelled into ghost clinics.
This scandal exposed the deep-rooted corruption within Kenya’s healthcare system and led to significant public outcry.
Saini was also at the centre of the illegal importation of the Sputnik V COVID-19 vaccine.
Documents revealed that Saini, through his company Dinlas Pharma, was involved in a deal to import one million doses of the vaccine from Russia.
The vaccine was procured at a price almost double the factory price and was intended to be sold at an even higher price in Kenya.
This deal was part of a larger scheme linked to Emirati royalty, further demonstrating Saini’s deep connections and influence in both local and international circles.
In addition to these scandals, Saini’s name has been tied to the Teachers Service Commission (TSC)-AON Minet scandal.
This scandal revolves around the mismanagement of medical insurance schemes for teachers, police officers, and prison officers in Kenya.
Saini owns Medical Administration Kenya Ltd. Ltd. (MAKL), a company that handles insurance claims for private hospitals.
MAKL has been accused of intentionally frustrating insured individuals, leading to delays in treatment, and forcing patients to pay out-of-pocket expenses.
MAKL is responsible for administering the medical insurance schemes for teachers and police officers.
The company has been accused of negotiating low capitation fees with hospitals, which has resulted in poor service delivery.
Hospitals contracted by MAKL often deny services or create obstacles that force patients to seek treatment elsewhere, usually at their own expense.
This situation has caused suffering for the insured, who are left without adequate medical care despite the government allocating billions of shillings to these schemes.
Jayesh Saini’s involvement in these scandals has raised serious concerns about the state of Kenya’s healthcare system.
His ability to manipulate the system for personal gain, often at the expense of ordinary citizens, highlights the need for stronger oversight and accountability in the management of public health resources.
Dr. Umesh Saini has three children: Dr. Umesh Chandra Mina, Dr. Umesh Chandra Tina, and the notorious Jayesh Saini.
Dr. Mina and her sister Tina run the Nairobi West Hospital together with their father, Dr. Saini.
Jayesh, on the other hand, runs his own show separate from the sisters and father. He owns Bliss Healthcare, the LifeCare Group of hospitals, and a plethora of other businesses, including pharmaceutical companies. He handles the political side of things.
Jayesh and his family (his wife is a pharmacist) are protected by members of the presidential unit, who are personally recommended by the president.
Just like Adani is from Gujarat, the Saini’s are from Rajasthan. Mohan Galot is a business tycoon who supplies police and military uniforms through Manchester textiles and also owns London distillers, his sister is Dr Umesh Saini’s wife (owner of Nairobi West Hospital). He is allegedly the one who gave Dr. Umesh political connections.
Sources indicate that President William Ruto does not use the hospital, but his children June, Nick, and his wife, George Kimutai, use it frequently. They use a separate parking lot from the rest (the same one that the founder, Dr. Saini, uses) to access an exclusive elevator to the VVIP section on the 8th floor.
According to more sources privy to the dealings at murmured to Kenya journalist Nelson Amenya and revealed how Jayesh Saini and his family have captured our public healthcare.
“Hello Nelson, I have worked at Nairobi West Hospital. Jayesh’s sister, Dr. Mina, is the director and has been in her office. That same Jayesh Saini owns MAKL; now I’ll speak about MAKL since I have been there as a medical analyst.
“The current director is called Parmanand Mishra; they brought in another guy recently called Ranmeet, a very racist guy. They have contracted more than 700 hospitals and have given high capitation to their facilities, that’s LifeCare hospitals and Nairobi West.
“We were being told not to approve any case of malaria or any tropical disease to be managed as inpatients, but at their facilities in Tunambiwa, we should not reject any case; we approve Zote.
“I received several calls from irate parents, teachers, and our police officers. Inafika Inafika Hadi Mahal Mahal My parents travel to the headquarters office to personally seek approval. The office is located at the Arch Place, Nyangumi Road, opposite Somerset Hotel, 7th floor.
“Ukipatikana, you have approved a case to any other facility; you are questioned, or if it’s genuine (all cases are genuine), you are told to either allow only 24 hours, then force discharge or if it’s surgery, negotiate for the lowest offer.
“There are several departments from pre-authorisation to extension audit discharge until claiming. In the Kila department, you are forced to slash the bill. For instance, you issue an LOU of three days for a patient, and the bill for three days comes to about Ksh50,000.
“After 24 hours, the case is put on hold and the facility told to discharge a patient who has not recovered. They seek an extension that is still denied. If granted, you are given another 24 hours, then forced to discharge thereafter. The discharge team should approve 70% of the total bill.
So, Kuna deductions inaenda auditing at 70% inakatwa another 10% unaambiwa you did some unessessary test or with any reason yenye haiadd up. Haya then inaenda claims department.
“Hapa ndio maajabu hufanyika aim hukuwa kureject the whole bill. Silly reasons you did not attach cardex or prescription, the whole bill Inakuwa declined and if it’s not declined, the now 60% remaining wanaslash another 30 or 20 Inakuwa approved the remaining 40 probably 15k or there about from 50k.
” Haya service provider akifanya reconciliation asipo peana discount halipwi. 10% ndio huwa discount. You end up getting very little. Nelson, you are a service provider for USPS services. Alafu unafanyiwa hivi that discount inakuwanga ya Mishra. but za hospitali zao all are approved 100%, especially Nairobi West, and paid on time.
“The aim of Nairobi West is to deplete patient coverage. They even call and ask if that particular patient has depleted the cover or not. When the cover is depleted, they refer you to a government facility.
” I can give you classical cases, but due to patient confidentiality, inaezakuwa noma. Sometimes they even suspend teachers from attending their facility, and it’s contracted. Imagine then if you do research.
“Hospitals are not accepting teachers and police in some of these hospitals on Ziko Huko Rusinga Island. They barely see 50 patients a month with a capitation of 900 or 1500 at most, and then out of the 50 cases, you only get reconciliation for 10 patients na hosi pesa imelala hata two years. There is a lot of rot in that company and bribery.”
