Government has announced a new plan to fully settle claims of up to Ksh. 10 million made by health facilities that were previously contracted by the now-defunct National Health Insurance Fund (NHIF).
President William Ruto revealed the decision on Wednesday. He went on to explain that these claims, which cover public, private, and faith-based hospitals, represent a significant 91 percent of all NHIF-affiliated facilities.
However, hospitals with claims exceeding Ksh.10 million will undergo a thorough verification process. The process is expected to be completed within 90 days. After this, a payment plan will be established.
“The remaining 9 percent of hospitals, with total claims of above Ksh.10 million, will be subjected to a verification exercise that should be completed within 90 days, after which a payment plan will be agreed on,” President Ruto explained.
“The Cabinet Secretary will gazette the verification committee within a week.” He went on.
The government also pledged to clear all outstanding arrears monthly. This is in response to the challenges surrounding the newly formed Social Health Authority (SHA). As of now, Ksh.18.2 billion worth of undisputed claims have already been paid out. “Under the Social Health Authority, current claims will continue to be paid within a month. To date, SHA has paid all undisputed claims lodged since its inception on October 1, 2024. Up to January 31, 2025, SHA paid a total of Ksh.18.2 billion,” the President stated.
Additionally, Ruto reaffirmed the government’s commitment to Universal Health Coverage (UHC) for all Kenyans. He stressed that any issues arising with the Taifa Care system, which was introduced to replace NHIF, are being addressed. Despite criticism of the new digital healthcare platform, particularly regarding system failures in hospitals, Ruto defended it. He claimed it would help combat the corruption and fraud that previously plagued NHIF.
He also suggested that the negative publicity surrounding SHA largely stems from individuals who exploited NHIF’s loopholes, diverting as much as 40 percent of the fund. “No amount of propaganda will force the government to go back to NHIF, and thus give crooks another chance to continue stealing public funds,” President Ruto concluded.
