Tanzania: Negligent Health Workers Face NHIF Surcharge

Tanga — TANGA Regional Commissioner Dr Batilda Burian has warned that health workers who negligently process National Health Insurance Fund (NHIF) claims and cause financial losses to public health facilities will be personally surcharged.

The directive was issued during a special meeting of the Pangani District Council convened to discuss the Controller and Auditor General's (CAG) report, which highlighted persistent weaknesses in the preparation and processing of NHIF reimbursement claims.

Dr Burian said errors and negligence in handling NHIF documentation have led to the rejection of legitimate claims, depriving health facilities of much-needed revenue and undermining efforts to improve healthcare services.

"Those responsible for losses arising from negligence in processing NHIF claims must be held personally accountable. Public funds cannot continue to be lost because of carelessness," she said.

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She directed council directors and district medical teams to immediately organise refresher training for staff responsible for preparing and submitting NHIF claims to ensure that all claims are processed accurately and within the required timelines.

Dr Burian further said the CAG has repeatedly raised concerns over weaknesses in processing NHIF claims, noting that the resulting loss of reimbursements has negatively affected the financial capacity of health facilities and service delivery.

According to the auditor's recommendations, local authorities should strengthen internal controls and ensure strict adherence to NHIF guidelines to reduce claim rejections and recover eligible payments. Dr Burian also criticised local government authorities for failing to remit operational grants to village governments as required by law.

She said councils are obligated to transfer operational funds to village administrations every quarter, but compliance remains poor, limiting the ability of grassroots institutions to effectively carry out their responsibilities. Dr Burian directed all outstanding payments to be settled by July 15 this year and ordered councils to assist villages whose bank accounts have become inactive.

"Some village accounts have been closed. Councils must help reactivate them so that village governments can discharge their responsibilities effectively," she said.

She warned that the lack of operational funds could expose village leaders to corrupt practices or encourage the imposition of unauthorised charges on residents. On youth economic empowerment, Dr Burian urged councils to move beyond merely registering groups under the National eProcurement System (NeST) and ensure they receive practical support to participate in government procurement opportunities.

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"The target is not simply to register 150 groups. Councils must ensure these groups are trained, empowered and connected to tender opportunities as directed by President Samia Suluhu Hassan," she said.

She added that progress in implementing the programme would be assessed during the next Uhuru Torch race. The Regional Commissioner also directed councils to mobilise elderly citizens to form groups and benefit from the initiative, noting that the programme offers opportunities to older people unlike the traditional 10 per cent loan scheme.