On April 7, 2025, Cabinet Secretary for Health, Hon. Aden Duale, inaugurated the NHIF Pending Medical Claims Verification Committee at Afya House in Nairobi. The committee was established through Kenya Gazette Notice No. 4069, dated March 28, 2025, with the responsibility of reviewing and verifying pending medical claims submitted to the National Health Insurance Fund (NHIF) between July 1, 2022, and September 30, 2024. The committee is tasked with making recommendations to the Ministry of Health regarding the settlement of verified claims and ensuring the process is carried out with transparency and accountability.
During the inauguration, Hon. Duale expressed confidence in the committee’s ability to handle this important task, emphasizing the need for thoroughness and objectivity in reviewing the outstanding claims. He acknowledged the financial challenges faced by some healthcare providers but stressed that the entire verification process must be guided by principles of transparency, accountability, and value for money. Hon. Duale pointed out that restoring public trust in the health financing system is a critical objective, and the committee’s work is an essential step towards achieving this goal.
The Cabinet Secretary also highlighted the government’s ongoing commitment to Universal Health Coverage (UHC) as part of the Bottom-Up Economic Transformation Agenda (BETA), which aims to ensure that every Kenyan has access to affordable and quality healthcare. He noted that the successful execution of this committee’s mandate will contribute to the overall goal of improving health outcomes for all Kenyans.
The Chairperson of the committee, Mr. James Masiro, acknowledged the scale and urgency of the task at hand. In his address, he reassured the Ministry of Health and the public that the committee was fully committed to completing the verification process within the specified timelines. Mr. Masiro underscored the importance of teamwork, integrity, and diligence in carrying out the work, emphasizing that the success of the committee’s mission depends on the professionalism and cooperation of all its members.
The committee’s work is vital in ensuring that the NHIF operates efficiently and fairly, particularly in addressing the concerns surrounding pending medical claims. By thoroughly examining and verifying claims, the committee will help identify any discrepancies or irregularities, providing a basis for recommendations on how to resolve outstanding payments. This process is expected to enhance the credibility of the NHIF, which plays a crucial role in providing health insurance coverage to millions of Kenyans.
The inauguration event was attended by several key figures from the Ministry of Health, including Principal Secretaries Mary Muthoni (Public Health and Professional Standards) and Harry Kimtai (Medical Services), as well as Director-General for Health, Dr. Patrick Amoth. Other notable attendees included Social Health Authority Acting CEO, Mr. Robert Ingasira, and the SHA Chairperson, Mr. Abdi Mohamed. Together, these leaders emphasized the importance of the committee’s work and reaffirmed their support for the committee’s mission to restore confidence in the NHIF system.
As the committee moves forward with its task, it is expected to play a crucial role in improving the efficiency and transparency of the National Health Insurance Fund, ensuring that the funds are used appropriately to improve healthcare access and outcomes across the country. The public’s trust in the system will be strengthened through rigorous verification and careful attention to detail, ultimately contributing to better healthcare for all Kenyans.
