Nairobi: Health Cabinet Secretary Aden Duale has officially launched the National Health Insurance Fund (NHIF) Pending Claims Verification Committee to scrutinize and validate outstanding medical claims submitted between July 1, 2022, and September 30, 2024.
According to Kenya News Agency, Duale emphasized during the launch that the government is committed to settling all legitimate claims. He stated that hospitals with claims below Sh10 million will be paid without delay, while the remaining 9 percent, whose claims exceed Sh10 million, will undergo a thorough verification exercise within 90 days. After this period, a payment plan will be agreed upon for all genuine claims.
Duale stressed that the committee's mandate is to establish a framework to assess claim authenticity, recommend action on fraudulent submissions, and propose reforms to prevent future accumulation of unverified claims. He challenged the committee to identify and eliminate any fraud or corruption in the healthcare financing system, recommending necessary disciplinary or legal action where wrongdoing is found.
He also highlighted the initiative as part of a broader effort to restore public trust, transparency, and accountability in the management of healthcare funds. Addressing financial constraints in the sector, Duale acknowledged challenges facing key healthcare providers but insisted on fiscal prudence, affirming that value for money, transparency, and accountability are essential.
Duale warned that the committee would be held accountable for any payments made for services not rendered and urged healthcare providers, NHIF management, oversight agencies, and the public to support the committee's work in fostering integrity and fairness.
Committee chairperson James Masiro assured stakeholders of their commitment to delivering accurate, risk-based verification, emphasizing integrity, diligence, and teamwork in their mission.