How Jayesh Saini and His Family Have Captured Our Public Healthcare

The capture of public healthcare services by private players like Jayesh Saini and his family is a major threat to the integrity of Kenya’s healthcare system.

The preferential treatment of their facilities, coupled with the exploitation of public resources, has left many Kenyans without access to proper medical care.

It is high time that the government and relevant authorities launch a thorough investigation into these practices to ensure accountability and restore the public’s faith in the healthcare system.

The public healthcare system in Kenya is facing a myriad of challenges, and recent revelations suggest that the situation is far worse than previously understood.

The involvement of private players like Jayesh Saini and his family in Kenya’s healthcare sector is raising serious concerns about corruption, patient care, and the manipulation of medical services for profit.

Also Read: How Jayesh Saini, Owner of Bliss, Nairobi West Hospital, and MAKL, Bribe the Senate Committee in the Missing Sh176 Billion

Jayesh Saini’s Network in Healthcare

Jayesh Saini, a key player in the healthcare industry, owns several facilities, including Nairobi West Hospital, LifeCare Hospitals, and MAKL. Through these institutions, Saini and his associates have allegedly established a stronghold over healthcare services provided to key public sectors such as teachers and police officers, under the administration of the National Health Insurance Fund (NHIF).

One whistleblower who worked at Nairobi West Hospital shares inside information about how the Saini family manages these facilities. Dr. Mina, Jayesh’s sister, serves as the director of Nairobi West Hospital, while MAKL is run by individuals like Parmanand Mishra and a newly introduced director, Ranmeet, who has been described as racist by staff.

How Jayesh Saini and his family have captured our public healthcare.

I have worked at Nairobi West Hospital. Jayesh’s sister, Dr. Mina is the director, 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 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 coerced not to approve any case of malaria or any tropical disease to be managed as an inpatients, but at their facilities tunambiwa we should not reject any case we approve zote. I received several calls from irate parents teachers and our police officers. inafika Hadi MahalI 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 24hrs then force discharge or if it’s surgery negotiate for the lowest offer. There are several departments from pre-authorization to extension audit discharge until claiming. 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 50k.

After 24hrs the case is put on hold and the facility is told to discharge a patient who is not recovered. they seek for extension that is still denied. If granted, you are given another 24hrs 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 unessesary test or with any reason yenye haiadd up. Haya then inaenda claims department. hapa ndio maajabu hufanyika. hapa 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 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 ushapeana 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 patients cover. 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 goverment facility.

I can give you classical cases but due to patients confidentiality inaezakuwa noma. sometimes they even suspend teachers from attending their facility and its contracted imagine then if you do research. Hospitals are not accepting teachers and police some of these hospitals ziko huko rusinga island. they barely see 50 patients a month with a capitation of 900 or 1500 at most then out of the 50 cases you only get reconciliation ya 10 patients na hosi pesa imelala hata two yrs. There is a lot of rot in that company and bribery.

MAKL’s Role in Public Healthcare

MAKL contracts over 700 hospitals across the country. However, hospitals affiliated with Saini’s network, such as Nairobi West and LifeCare hospitals, are given preferential treatment through higher capitations and lenient approval processes. On the other hand, non-affiliated hospitals struggle to get approvals for basic treatments like malaria or tropical disease management.

The whistleblower revealed that staff at MAKL were instructed to reject cases from other facilities, while automatically approving all cases from Saini’s hospitals. This double standard has led to patient suffering, especially among teachers, police officers, and their families, who often have to travel long distances to get approvals for treatments.

Exploitation of Public Resources

The whistleblower also describes how medical bills are manipulated and slashed at various stages of treatment approval. Patients are often prematurely discharged before they are fully recovered, and facilities struggle to get proper compensation for the services they provide. Multiple departments at MAKL are responsible for slashing hospital bills, with each department cutting costs for arbitrary reasons, leaving hospitals with as little as 40% of the original bill.

Hospitals that do not comply with MAKL’s demands are often suspended or not paid on time, leaving them financially crippled. In contrast, Nairobi West and LifeCare hospitals receive full payments on time and are often paid in excess to deplete a patient’s cover. Once a patient’s insurance cover is exhausted, they are quickly referred to public facilities.

Bribery and Corruption

The whistleblower describes widespread corruption within MAKL, stating that hospitals in remote areas like Rusinga Island, which see fewer than 50 patients a month, are still given high capitations. However, these hospitals often do not receive full payment or have their claims processed. Many hospitals have had to wait years to get payments reconciled, while Nairobi West and LifeCare are approved and paid on time.

The rot within MAKL is allegedly driven by bribery, with Mishra and other top officials benefiting directly from these financial manipulations. The whistleblower suggests that a thorough investigation is needed to reveal the full extent of the corruption and exploitation that is taking place.

Jayesh Saini: