The Social Health Authority (SHA) has issued an update on the payment of verified pending claims of Ksh10 million and below arising from the defunct National Health Insurance Fund (NHIF).
In a statement on Wednesday, August 12, the authority said the payments are being processed following a claims verification and sign-off exercise involving healthcare facilities.
SHA noted that the payments will be released in four batches, with the first batch already processed.
"Following the claims verification and sign-off exercise, payments will be made in four batches. The first batch has been processed, and the list of facilities paid in this batch is attached and available on the SHA website at https://sha.go.ke/," the statement read.
SHA called on healthcare facilities that require clarification on their claims to work closely with its teams and submit any documentation needed to facilitate completion of the payment process.
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"Facilities requiring clarification are requested to cooperate with SHA teams and provide any supporting information or documents required to complete the process," the statement added.
Elsewhere, this comes days after Health Cabinet Secretary Aden Duale defended the service fee charged on claims processed through the national digital health system.
In a statement on Tuesday, August 4, he responded to a report published by a local newspaper, saying it had created a misleading impression about the legal framework governing the fee.
Duale said the government had undertaken an unprecedented reform by placing the country's entire health financing system on a single digital platform.
He explained that the 2 percent charge is provided for under Regulation 11(2) of the Digital Health (Data Exchange Component) Regulations, 2025.
Duale said the regulation requires users of the Health Information Management Service (HIMS) to pay a service fee, with the Third Schedule capping the amount at Ksh5,000 regardless of the value of the claim.
"It is therefore a capped fee for the use of a system. It is not an open-ended share of any hospital's earnings," the statement added.
According to Duale, the fee is paid directly to the Digital Health Agency (DHA) which was established under the Digital Health Act, 2023.
He said the agency is legally mandated to operate the Comprehensive Integrated Health Information System and is authorised by law to collect levy fees for services it provides.
"This is a charge by a public body, for a public system, authorised by statute," the statement further read.
Duale also rejected suggestions that private entities control or receive healthcare funds intended for hospitals.
He said only Social Health Authority (SHA) has the legal mandate to review, process and pay claims to contracted healthcare providers, adding that all money received by the DHA is public money subject to statutory oversight and auditing.
"There is no parallel account and no hidden ledger. There is the ordinary constitutional process of public audit, and it applies here exactly as it applies to every other State agency," the statement explained.
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