Government to pay out ksh 1.5 billion in claims owed to healthcare facilities
The government has said it will disburse Sh1.5 billion this week to settle claims owed to healthcare facilities.
Medical Services Principal Secretary Harry Kimtai said an additional Sh3 billion will be sent next week, bringing the total to Sh4.5 billion.
Kimtai said that claims owed by the defunct National Hospital Insurance Fund (NHIF) will be fully paid.
NHIF transitioned to the Social Health Authority (SHA) on October 1.
SHA is mandated to manage the new Social Health Insurance Fund (SHIF), which offers enhanced medical health cover.
“We are optimistic that we will settle all the claims,” Kimtai said in a statement dispatched by the ministry Tuesday evening.
The PS said a committee will be established to oversee the payment process to ensure there’s transparency.
A number of health facilities were previously accused of colluding with rogue NHIF officials to make falsified claims, resulting in Sh10 billion in losses every year.
An internal audit revealed that some hospitals would present claims of major surgeries when a patient had undergone a minor procedure.
Other claims were through impersonation, where a patient not registered would use the NHIF card of a registered contributor and have the hospital bill the fund under the cardholder's name.
PS Kimtai said following the October 1 migration, all NHIF liabilities now fall under SHA, which has implemented a fully digitised claims portal to avert fraud.
The PS assured that all outstanding claims will be settled within 90 days.
“As of yesterday (Monday), over Sh100 million worth of claims had been recorded with the system enabling real-time monitoring,” he said.
PS Kimtai said as part of the digitization of health records, SHA would additionally distribute tablets to healthcare workers for record taking and monitoring.
He further added that the adoption of e-contracting for healthcare facilities, which will replace the previous manual system, would help transform the healthcare system.
The PS urged facilities to establish customer service desks to help Kenyans register with SHA.
