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The government has paid up to 90 per cent of the hospital claims since the Social Health Authority (SHA) scheme was rolled out on October 1.

This is what it owed health facilities for October and November. There are also hopes that before the end of January, the authority, which took over from the National Health Insurance Fund (NHIF), could have fully reconciled all the claims by hospitals.

“As we sit here, 90 per cent of the claims for October, and November under SHA have been paid,” acting Chief Executive Officer, Robert Ingasira told People Daily.

While exuding confidence that the authority is currently in the process of clearing December claims, Ingasira said that the move is a way of building confidence among health facilities.

The CEO also announced that while the reconciliation process is ongoing, SHA is working closely with the hospitals to ensure that they know how much they are owed. Designated fund However, it could be difficult for the authority to use the money in its accounts to settle claims incurred by the defunct NHIF, since what’s in its possession is insulated and in designated funds.

He explained that the monies under SHA are in the authority’s accounts, whereas what is with Primary Health, which is Exchequer-funded, is in a designated fund.

This is also the same case as monies under the Emergency, Critical and Chronic Illness Fund, which are also in a designated fund. Ingasira said it is not possible to use such monies to pay all the debt because the law has protected it.

“So it is not mixed up, and it’s possible to continue paying what’s being incurred by the hospitals,” he pointed out. More disbursements As of January 1, 2025, the government-owned hospitals had an estimated Sh30 billion in debts incurred by the defunct institution.

However, according to Ingasira, the government has been working to address the debt. Records at the Ministry of Health show that as of November 2024, it had already paid out Sh5.05 billion.

The government also announced that it would release an additional Sh2.5 billion. The government has formed a committee to oversee claims payment and disbursement of funds. Ingasira feels that the inconsistencies between how much was owed to hospitals could have originated from the way hospitals generated claims.

He noted that hospitals were expected to carry those claims to the SHA branches. where the initial verification of some of those claims would take place.

The Rural and Urban Private Hospitals Association had threatened to stop providing treatment to SHA patients starting January 1, unless the debt was paid. The association said that patients would be forced to pay cash for medical services.