EXPOSED: SHA Reveals Fraud Claims From NHIF Transition Process
The Social Health Authority (SHA) has announced several changes to combat false claims, including the engagement of investigative agencies.
This comes after disputes between the government and healthcare providers have hampered services in private hospitals for a subset of government employees seeking treatment.
In a statement released on Wednesday by State House Spokesperson Hussein Mohamed and State House Economic Council advisor Moses Kuria, SHA revealed that some facilities were submitting false claims.
In response, the authority stated that it had notified investigating agencies to conduct an audit of the claims.
The facts about Taifa Care payments : pic.twitter.com/xYQN31uqwW
— Hussein Mohamed, MBS. (@HusseinMohamedg) February 26, 2025
“Regarding the old debts owed to Facilities by the defunct NHIF, whereas some of the claims are genuine, it has come to the attention of the relevant authorities that some claims were pushed through as we came close to the transition to SHA in order to create liabilities,” a statement from SHA read in part.
“The investigative agencies are seized of the matter and soon the wheat will be separated from the chaff and necessary action will be taken,” it added.
The statements came just a few days after the Rural and Urban Private Hospitals Association of Kenya (RUPHA) stated on Thursday, February 20, that it will delay care for SHA patients beginning Monday, February 24.
While making the statement, the chiefs of RUPHA also stated that their hospitals would stop treating select civil officials with government-backed insurance beginning Monday.
“We will stop providing medical services (to some civil servants) using the government insurance from Monday,” announced Rev Joseph Kariuki, Deputy Chairperson of RUPHA.
On Tuesday, SHA CEO Robert Ingasira told patients that the administration was working around the clock to resolve the standoff.
We owe healthcare providers. Initially, it was Ksh 19 billion; Ksh 9 billion was paid between October and November. – Robert Ingasira, Ag. CEO SHA.#NewsDesk pic.twitter.com/EpcqDk9YT9
— KTN News (@KTNNewsKE) February 25, 2025
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However, the CEO expressed concern about the delay in paying some health institutions, which he attributed to a dispute on pending invoices.
Meanwhile, SHA has announced adjustments to its patient payment system.
They added that patients will be contacted via a short message service (SMS) once hospitals have received paid for the services rendered.
“Effective 1st March 2025, patients will receive an SMS once the hospital receives payment for their treatment. There will be no one to mislead,” SHA said in a statement.
EXPOSED: SHA Reveals Fraud Claims From NHIF Transition Process
