Health Cabinet Secretary Aden Duale has said the Ministry of Health will respect the court’s decision declaring the National Health Insurance Fund (NHIF) Pending Medical Claims Verification Committee unconstitutional.
In a statement on Thursday, August 14, Duale, however, said that due process will still be followed in settling the bills.
He noted that existing constitutional provisions and relevant laws would guide the ministry’s next steps on the matter.
"The Ministry of Health under my leadership will uphold and respect the decision of the court but we shall be guided by the same constitutional provision of articles 223, 206(1)(b), public finance management Act 2012, public procurement and Asset Disposal act 2015, Appropriations act, Anti corruption and Economic crimes act, parliamentary oversight on how the NHIF pending bills will be settled," he stated.
Duale stated while the structure of the committee might change, the principle of verification remains non-negotiable.
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"Verification of the pending claims is not negotiable and we shall protect public resources. We shall consult on how the verification will be down in accordance with the supreme law of the land," he added.
The High Court in Eldoret on Wednesday, August 13, nullified the creation of the committee, terming it illegal.
In his ruling, Justice Reuben Nyakundi said the committee’s formation went against Article 31 of the Constitution when read together with the Social Health Authority Act.
The court determined that neither the supreme law nor the statute allowed for the creation of such a panel.
“There was no legal basis for the establishment of the committee. The transitional provisions of the Social Health Insurance Act do not provide for the formation of any committees to establish the liabilities of the NHIF,” the judge ruled.
The formation of the committee was announced earlier in the year to address the backlog of unsettled medical claims.
The committee's primary task was to scrutinize all pending claims accumulated between July 1, 2022, and September 30, 2024.
It would also evaluate the legitimacy of the claims, ensuring that genuine submissions are settled while fraudulent or irregular ones are flagged for appropriate action.
“The Government has constituted the National Health Insurance Fund (NHIF) Pending Medical Claims Verification Committee to address the backlog of unsettled medical claims.
"It will make recommendations on the settlement of genuine claims while identifying and flagging any fraudulent or irregular submissions for appropriate action," Duale said at the time.
