SHA headquarters in Nairobi/ FILEThe Social Health Authority has started surveillance and verification of pending claims inherited from the defunct National Hospital Insurance Fund, targeting claims worth Sh10 million and above ahead of planned payments in the 2026/27 financial year.
Healthcare providers with claims covered by the exercise have been asked to check the schedule issued by SHA and prepare the required documents for verification.
In a notice, SHA said it had commenced the surveillance and verification exercise for pending defunct NHIF claims of Sh10 million and above.
“SHA has commenced the surveillance and verification of pending defunct NHIF claims of KES 10 million and above as per the attached schedule,” the authority said.
The authority advised healthcare providers to review the schedule and prepare the required documentation to facilitate the exercise.
The latest process comes as SHA moves to address outstanding liabilities inherited from NHIF following the transition to the new health insurance system.
SHA had previously said it was seeking budgetary support from the National Treasury in the 2026/27 financial year to settle verified outstanding claims exceeding Sh10 million per healthcare facility.
The authority said the funding request covers claims owed to 451 healthcare facilities, adding that the claims had already undergone the required verification process.
The latest surveillance exercise will focus on the claims listed in the schedule as SHA prepares for the next stage of the payment process.
Healthcare providers have been urged to ensure they have the documents required by the authority when their claims are subjected to verification.
The exercise follows a Sh4 billion release by the government in July to begin settling verified outstanding claims owed to healthcare facilities by the defunct NHIF.
The July payment programme covered a different category of claims, with SHA saying the funds would be used to settle verified claims amounting to Sh10 million and below.
The authority said the Sh4 billion would benefit 3,527 healthcare facilities across the country.
SHA conducted a nationwide sign-off exercise before the release of the funds, requiring eligible facilities to sign agreements confirming that their verified defunct NHIF claims had been fully settled.
“Eligible healthcare facilities will be required to execute sign-off agreements confirming that their verified defunct NHIF claims have been fully settled,” SHA said at the time.
The authority deployed teams to its county offices to coordinate the exercise and assist healthcare providers with the required documentation.
SHA said completion of the sign-off process would pave the way for the release of payments to eligible facilities.
The exercise was conducted in phases across the country, with healthcare facilities from different counties assigned regional stations for the sign-off process.
SHA said the list of the 3,527 eligible healthcare facilities was available on its website and at its county offices.
The authority separately said it was seeking Treasury funding to settle claims exceeding Sh10 million per healthcare facility, with the funding request covering the 451 facilities.
The current verification exercise targets that higher-value category as SHA continues preparations for settling outstanding claims inherited from the defunct NHIF.
