NHIF Claims Under Review as Health CS Launches New Committee

By Aoma Keziah,

Cabinet Secretary for the Ministry of Health Aden Duale, accompanied by PS Mary Muthoni (Public Health and Professional Standards), and PS  Harry Kimtai (Medical Services), has officially launched the NHIF Pending Medical Claims Verification Committee, following a directive issued by  President WilliamRuto, which mandates the immediate settlement of all verified claims amounting to Ksh 10 million and below.

The committee, gazetted under Kenya Gazette Notice No. 4069 dated March 28, 2025, has been tasked with verifying outstanding claims by healthcare facilities contracted under the National Hospital Insurance Fund (NHIF).

“We have taken this step to restore public trust, accountability and transparency in the financing of healthcare system in Kenya.This Committee has been established to provide an independent, thorough, and transparent review of medical claims submitted to the defunct NHIF which to date, remain unpaid. The available records indicate that the defunct NHIF owes Health Care Providers approximately Kshs. 33 billion,” said Duale.

He futher directed the committee to scrutinize and recommend only genuine claims for payment.

“I urge and challenge this  Committee to thoroughly scrutinize the outstanding claims and only recommend the genuine claims for payment. the Government appreciates the financial difficulties being faced by some of these health care providers, it is important that this process is undertaken to guarantee not only value for money but also transparency and accountability in the purchase of health care services,” remarked Duale

The health CS expressed his confidence in the committee leadership, chaired by Mr. James Masiro and his Deputy Dr. Anne Wamae, emphasizing that all healthcare providers will be paid.

“I have full confidence that this Committee and its Secretariat  will do good work and after verification, all genuine claims of healthcare providers will be paid and this Committee will be held responsible for payment made to services not provided,” added Duale

These payments will cover 91% of all facilities contracted by NHIF, the remaining 9% of facilities  with claims exceeding Ksh 10 million, will undergo a rigorous 90-day verification exercise, led by the newly formed committee. Upon completion, a structured payment plan will be developed to settle the outstanding amounts.

“We will be desired to examine 100% of the fields. Subject to the time before us, we have to be smart in terms of design of our approach. We will deliver  the best result at the end of our service and I assure you this team will work as one,” noted Mr. James Masiero Ojee Chairperson of NHIF Pending Medical Claims Verification Committee

The launch of this committee marks a turning point in the management of public health finances  reflecting the government’s commitment to enhancing trust and efficiency in NHIF operations. The Ministry reiterated its dedication to ensuring that healthcare providers across the country are supported in delivering quality services to all Kenyans.