The newly appointed Health Cabinet Secretary, Aden Duale, has constituted a committee to help scrutinise and determine the legitimacy of pending bills owed to hospitals by the now-defunct National Health Insurance Fund (NHIF).

Through a special gazette notice, CS Duale confirmed the formation of the National Health Insurance Fund (NHIF) Pending Medical Claims Verification Committee.

According to the notice, the committee will be chaired by James Masiro Ojee, who will be deputised by Anne Wamae.

Members of the verification committee 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.

They will be assisted by a secretariat comprising Peter Kitheka (Head of the Secretariat), Shawn Mogaka, Consolata Ogot (Dr.), Emmanuel Ayodi Lusigi (Dr.), Halima Yussuf and Wilbert Kurgat.

The Ojee-led committee will serve for three months, and they shall be domiciled at the Social Health Authority building

Task ahead

Duale, who was recently moved by the Environment docket to Afya House, tasked the committee with scrutinising pending claims accumulated from July 1, 2022 and September 30, 2024 and then give a recommendation to the Ministry of Health on the way forward.

“Establish a clearly defined criteria for detailed examination and analysis of such pending medical claims with a view to determining the genuineness of each or otherwise.

“Make recommendations to the Ministry of Health on the necessary actions to be taken for satisfactory disposal or settlement of the identified pending medical claims,” the special gazette notice read in part.

“Identify any cases where they may have been corrupt, fraudulent and false medical claims and make appropriate recommendations to the relevant Government agencies and propose reforms or measures that will ensure future accumulation of pending medical claims is avoided,” it added.

Ruto’s order

The latest order came after President William Ruto committed to clearing the NHIF debt. In a statement, the head of state announced that the payment of the Ksh10 million claim would be made to 91 percent of the hospitals that were contracted by NHIF.

He indicated that the remaining 9 percent of hospitals, with total claims above Ksh10 million, would be subjected to a verification exercise before releasing their claims.

He made the orders after private hospitals rejected the Social Health Authority (SHA) cover, over the money owed to them by NHIF. They directed patients to only pay in cash, threatening to plunge the country into a health crisis.