Health Cabinet Secretary Aden Duale has appointed a special committee to address the backlog of unpaid medical claims owed to hospitals by the now-defunct National Hospital Insurance Fund (NHIF).
In a special gazette notice, Duale stated that the National Health Insurance Fund (NHIF) Pending Medical Claims Verification Committee will assess the unsettled claims accumulated between July 1, 2022, and September 30, 2024.
The backlog has caused financial strain, particularly for private and mission-based hospitals.
“The committee will establish a clear framework to verify the authenticity of pending claims and recommend the settlement of genuine cases while identifying fraudulent or irregular submissions,” the notice read.
The 19-member committee will be chaired by James Masiro Ojee, with members including Edward Kiplimo Bitok, Meshack Matengo, Meboh Atieno Awour, Tom Nyakaba, Catherine Karori Bosire, Paul Wafula, Catherine Mungania, James Oundo, Jackline Mukami Njiru, Judith Awinja (Dr.), and David Dawe.
The secretariat will be led by Peter Kitheka, assisted by Shawn Mogaka, Consolata Ogot (Dr.), Emmanuel Ayodi Lusigi (Dr.), Halima Yussuf, and Wilbert Kurgat.
Beyond verifying claims, the committee will propose long-term reforms to prevent future backlogs and ensure a more transparent and efficient claims process.
However, legal experts have questioned the committee’s legitimacy, citing a recent High Court ruling that declared President William Ruto’s Presidential Task Force on Health Audit unconstitutional.
On March 6, Justice Bahati Mwamuye ruled that the task force had unlawfully assumed the role of the Kenya Human Resources Advisory Council, raising concerns that the newly formed NHIF committee could face a similar legal challenge.
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