NHIF to transfer Sh29bn medical claims to new Social Health Authority
Health CS Nakhumicha emphasised the need for verification and reconciliation in the settlement process.
The National Health Insurance Fund (NHIF) will transfer Sh29 billion in outstanding dues amounting to the newly established Social Health Authority (SHA).
Health Cabinet Secretary Susan Nakhumicha made the announcement, saying verification and reconciliation processes, to establish what the NHIF owed hospitals, were taking place.
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"Some claims have to be verified, then reconciled after that, and then payments can come through," she said, emphasising the need for thorough checks.
The decision to shift the responsibility of settling outstanding claims to SHA follows allegations of fraudulent activities by some hospitals, as well as the submission of fake medical claims to the NHIF.
Last June, the government started a nationwide verification process to identify and eliminate rogue providers who were exploiting the fund using deceptive claims.
CS Nakhumicha, who made the announcement last Friday, assured that the SHA would only honour genuine claims - those that meet the prescribed criteria and have undergone the necessary verification and reconciliation.
Noting their commitment to accountability, the minister said the SHA empanelment process would be stringent and would only include facilities that meet specified criteria.
"We shall not empanel rogue facilities," she said, adding those that met the mark would be gazetted, providing the public with information on authorised health providers.
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