SHA director Funds and Finance Management Jonathan Leisen and chief executive officer Dr Mercy Mwangangi before the Public Investments Committee yesterday /DOUGLAS OKIDDY




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The Social Health Authority (SHA) has announced it will start paying for patients seeking treatment abroad by the end of February.

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The authority had suspended such engagements as the new Act requires the authority first to procure hospitals overseas.

SHA CEO Mercy Mwangangi on Wednesday told Parliament the agency has already floated an ‘expression of interest’ and will by end of the month make public the names of successful facilities.

Speaking when she appeared before the National Assembly's Public Investment Committee on Social Services, Administration and Agriculture, Mwangangi said patients seeking treatment overseas will be capped at Sh500,000.

“Previously, NHIF had a guarantee for hospitals and that is why patients could get treatment. Under SHA now we have to follow all the rules of procurement, which means that SHA can only pay once the contractual obligations are in place,” Mwangangi said.

“In terms of overseas travel, at the moment we don’t have contractual obligations with those hospitals and therefore Kenyans will have to foot their own bills. However, we are in the process of engaging with the said hospitals and we will conclude the exercise by the end of February.”

She further explained that SHA will cover only 36 medical procedures that are not available locally.

These include liver, bone marrow and paediatric kidney transplants, joint repairs, and bone replacement, bone marrow transplants for blood cancers and voice box transplants.

Others in that category are fetal blood transfusions and treatment, stem cell transplant, complex congenital heart surgery, nerve treatment, and modern cancer treatment, amongst others.

She was responding to Machakos Town MP Caleb Mule’s concerns on how patients are stuck, as some of the hospitals have declined to offer them services until they get paid their dues.

“The situation is very sad because you don’t know when a patient will get sick. It is my suggestion that you (government) should settle the claims if the patient has receipts,” Mule said.

The SHA boss regretted that situation even as she explained her hands are tied by the new Act.

She further told the committee, chaired by the Navakholo MP Emmanuel Wangwe that the authority inherited Sh142 million in claims from the defunct National Hospital Insurance Fund (NHIF) owed to overseas hospitals.

This is part of the Sh33 billion SHA inherited from NHIF.

Wangwe urged the SHA to expedite the procurement process to ensure Kenyans get specialised medical treatment.

The overseas claims, she noted, are now undergoing verification before they make any payment.

Out of the Sh33 billion, they are planning to settle about 5,000 claims that have been verified to cost of Sh5 billion.

The balance of Sh27 billion will be paid once the verification exercise is done.

INSTANT ANALYSIS

The law currently requires SHA to procure hospitals abroad where patients are treated in medical cases that are not available in the country.