SHA Issues Update on Verification of Pending NHIF Claims

The Social Health Authority (SHA) has announced that the verification of pending claims worth Ksh 10 million and above from the defunct National Health Insurance Fund (NHIF) will resume on Monday, October 26.

In a notice on Sunday, October 25, SHA said the exercise will target Level 2, Level 3 and Level 4 healthcare facilities with pending claims under the former health insurance scheme.

"The Social Health Authority (SHA) informs Level 2, Level 3 and Level 4 healthcare facilities that the surveillance and verification exercise for pending claims of KSh 10 million and above relating to the defunct National Health Insurance Fund (NHIF) will resume on 26 October 2026," the notice read.

SHA asked all affected healthcare facilities to check their scheduled visitation dates and prepare the required documentation ahead of the exercise.

The authority directed the facilities to consult the schedule published on its official website to confirm when verification teams would visit their respective institutions. 

SHA also instructed the facilities to make available relevant claims records, invoices, evidence of services rendered and other supporting documentation required during the verification process.

Elsewhere, this comes days after the National Cancer Institute of Kenya (NCI-Kenya) announced plans to conduct nationwide inspections of previously inspected cancer management centres and hospitals.

In a notice on Monday, October 19, the Institute said the exercise, meant to assess the quality of cancer care and compliance with national guidelines, will start on Wednesday, October 21.

NCI stated that hospitals would be informed individually about their scheduled inspection dates and times.

"Take notice that the Institute shall conduct a nationwide inspection of previously inspected cancer management centres/hospitals from 21st October 2026, to assess the quality of cancer care and adherence to the National Guidelines for Establishment of Cancer Management centres, using the NCI-K Inspection Checklist. Your facility will be notified of its inspection date and time," the notice read.

NCI outlined three main objectives of the exercise, including guaranteeing quality cancer care across all cancer management institutions in the country.

The inspections will also seek to strengthen patient safety and improve patient management outcomes throughout the cancer care continuum, while supporting the onboarding of eligible facilities onto the Social Health Authority (SHA) oncology benefits package.

The institute said the onboarding process would be undertaken in line with Legal Notice No. 56 of 2025, which sets out tariffs for healthcare services.

As part of the preparations, the affected hospitals have been asked to provide the necessary documentation and ensure that their key officials are available throughout the inspection process.

"You are requested to make available your relevant regulatory documents, protocols, and relevant facility records, and to ensure that the officer in-charge and HMT are present throughout the inspection," the notice added.