Duale Establishes Committee to Scrutinize NHIF Debt
Health Cabinet Secretary Aden Duale has set up a special committee to examine and verify the legitimacy of outstanding bills owed to hospitals by the now-defunct National Health Insurance Fund (NHIF).
In a special gazette notice, CS Duale confirmed the formation of the National Health Insurance Fund (NHIF) Pending Medical Claims Verification Committee. This body will assess pending medical claims and ensure proper accountability in the settlement process.
Committee Leadership and Members
The committee will be chaired by James Masiro Ojee, with Anne Wamae serving as his deputy. Other members include Edward Kiplimo Bitok, Meshack Matengo, Meboh Atieno Awour, Tom Nyakaba, Catherine Karori Bosire, Paul Wafula, Catherine Mungania, James Oundo, Jackline Mukami Njiru, Judith Awinja, and David Dawe.
Additionally, a secretariat will support the committee, led by Peter Kitheka, alongside Shawn Mogaka, Dr. Consolata Ogot, Dr. Emmanuel Ayodi Lusigi, Halima Yussuf, and Wilbert Kurgat. The committee, which will function for three months, will operate from the Social Health Authority building.
Committee’s Mandate
Duale, who was recently transferred from the Environment Ministry to the Health Ministry, has tasked the committee with scrutinizing claims accumulated between July 1, 2022, and September 30, 2024. Their primary responsibility is to assess the legitimacy of these claims and recommend appropriate action to the Ministry of Health.
The committee has been directed to:
- Establish clear criteria for evaluating the validity of pending medical claims.
- Recommend actions for the settlement or disposal of legitimate claims.
- Identify and report fraudulent, corrupt, or false claims to relevant authorities.
- Propose measures to prevent future accumulation of unresolved medical claims.
Ruto’s Directive on NHIF Debt Settlement
This initiative follows President William Ruto’s commitment to clearing NHIF’s outstanding debt. The president announced that payments amounting to Ksh10 million would be made to 91 percent of the hospitals contracted by NHIF.
However, the remaining 9 percent of hospitals, which have claims exceeding Ksh10 million, will undergo a verification process before their payments are approved. The decision came after private hospitals rejected the Social Health Authority (SHA) cover due to unpaid debts from NHIF, forcing patients to pay in cash and raising concerns over a looming health crisis.
With the formation of this verification committee, the government aims to restore trust in the health insurance system and ensure transparency in handling medical claims.
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Duale Establishes Committee to Scrutinize NHIF Debt
