Hospitals and insurers among NHIF creditors as debt accumulates to Sh25.8 billion

Hospitals and insurers among NHIF creditors as debt accumulates to Sh25.8 billion

A key concern raised in the report was the 2.7 million unverified hospital-related claims, making it difficult to determine NHIF's actual outstanding liabilities.

The National Health Insurance Fund (NHIF) had accumulated debts amounting to Sh25.8 billion as of December 31, 2023, according to a report by the transition committee to the Social Health Authority (SHA).

The report, included in the NHIF Board's November 2024 Exit Report, shows that the largest portion of the debt stemmed from hospital-related claims, totalling Sh15.87 billion for local hospitals and Sh139.63 million for overseas claims.

Insurance companies were also owed Sh5.6 billion in claims and premiums, while deferred income stood at Sh3.6 billion. Other liabilities included trade creditors and rent deposits amounting to Sh568.9 million, alongside tax payables of Sh6.38 million.

"The transition review team was provided with a list of NHIF liabilities, which totalled Sh25.8 billion as of December 31, 2023.

Trade payables (hospital-related claims) were not verified due to the high number (2.7 million).

“High levels of unreconciled NHIF claims are also noted, indicating that NHIF cannot clearly identify its current outstanding claims. It is recommended that the SHA puts in place a mechanism to sub-lease the claims for readability," the report stated.

A key concern raised in the report was the 2.7 million unverified hospital-related claims, making it difficult to determine NHIF's actual outstanding liabilities. The transition committee flagged the high volume of unreconciled claims as a major issue.

Beyond these confirmed debts, NHIF also faced contingent liabilities amounting to Sh16.1 billion.

These included court cases, legal fees, tax arrears, and overseas payment guarantees. According to the report, court claims against NHIF stood at Sh14.9 billion, while legal fees reached Sh765 million.

The Kenya Revenue Authority (KRA) assessments for tax arrears were Sh373 million, with overseas payment guarantees totalling Sh52.4 million.

"The transition review team was provided with a list of NHIF contingent liabilities totalling Sh16.1 billion due to court cases, legal fees, default assessments, and overseas payment guarantees. It is recommended that the SHA monitors and takes appropriate action to mitigate these potential liabilities where possible," the report added.

To address the growing financial burden, President William Ruto announced measures to tackle the outstanding debts.

On November 17, 2024, he stated that the government would release an additional Sh2.5 billion to help settle NHIF debts. This comes after the earlier disbursement of Sh5 billion aimed at strengthening universal health coverage.

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