The Social Health Authority (SHA) has reopened the review process for healthcare facilities with verified outstanding claims inherited from the defunct National Hospital Insurance Fund (NHIF), giving hospitals another opportunity to seek clarification before payments are finalised.

In a notice issued on July 24, 2026, SHA said healthcare providers that had not completed the sign-off process for verified NHIF claims valued at Ksh10 million and below can now submit concerns regarding the amounts communicated by the authority.

The move is expected to benefit hundreds of hospitals that have raised questions over the verification of pending claims as the government continues implementing its plan to clear billions of shillings owed to healthcare providers by the former NHIF.

Hospitals asked to submit concerns

SHA Chief Executive Officer Dr Mercy Mwangangi said facilities seeking clarification must submit written requests by Friday, July 31, 2026, for review.

According to the notice, each submission must include the facility’s name, former NHIF facility code, pending claims amount, relevant claim reference numbers, a detailed explanation of the concern and supporting documents, including claims statements and reconciliation records.

“The Authority will review all submissions within three weeks after the deadline and communicate the outcome to individual facilities through the appropriate channels,” the notice stated.

SHA reiterated that the review process would be guided by verified claim records to ensure fairness and transparency.

Fresh step in clearing NHIF debt

The latest directive follows the government’s release of Ksh4 billion earlier this month to begin settling verified NHIF debts inherited by SHA after the transition from the National Hospital Insurance Fund.

The funds target verified claims of Ksh10 million and below, covering 3,527 healthcare facilities across the country. Before receiving payment, eligible hospitals were required to sign agreements confirming that the verified claims had been fully reconciled.

To facilitate the exercise, SHA deployed officers to regional county offices where healthcare providers completed the mandatory sign-off process before payments could be processed.

Why the review matters

The latest window suggests that some healthcare facilities either disputed the verified amounts communicated by SHA or had not completed the reconciliation process within the initial timelines.

Healthcare providers have for years complained about delayed settlement of NHIF claims, arguing that the outstanding debts have strained cash flows, disrupted procurement of medicines and affected service delivery.

Many hospitals have maintained that discrepancies in inherited NHIF records require careful reconciliation before claims can be considered fully settled.

By allowing facilities to present supporting documentation before payments are finalised, SHA hopes to minimise disputes and improve confidence in the settlement programme.

Government prioritising smaller claims

The settlement programme stems from a government directive prioritising payment of smaller verified claims while larger debts continue undergoing verification.

Under the current arrangement, hospitals with verified claims of up to Ksh10 million are being paid first, while facilities owed amounts exceeding that threshold will be considered under a separate financing programme once additional budgetary allocations are secured.

According to SHA, claims above Ksh10 million will require further funding from the National Treasury before payments can commence.

Transition from NHIF to SHA

The outstanding claims date back to the operations of the now-defunct NHIF, which was replaced by the Social Health Authority as part of Kenya’s wider health financing reforms.

The transition left SHA responsible for inherited liabilities running into tens of billions of shillings owed to public, private and faith-based healthcare facilities.

The government has maintained that settling the historical debts remains critical to restoring confidence among healthcare providers while strengthening the country’s new universal health coverage framework.

With the latest review window now open, hospitals that believe their verified claims require further clarification have until July 31 to submit their concerns before SHA concludes the review process and communicates individual decisions.