No fake bills, CS Duale warns hospitals over SHA payments

ERICK KYALO-KNA

Health Cabinet Secretary Aden Duale has warned that the Social Health Authority (SHA) will not pay for fictitious claims for services that Kenyans did not receive.

Speaking in Garissa town during the graduation ceremony of Madarasa Munawar, where he was the chief guest, Duale dismissed claims that the government was delaying hospital bill settlements.

He said SHA is following the law by conducting forensic audits, clinical reviews, and claim verifications before releasing funds. “We will only pay after due diligence.

SHA will carry out forensic audits and clinical reviews to ensure that the services provided are legitimate and that the Kenyan patient has actually received them,” Duale said.

He explained that hospitals complaining of non-payment are largely those whose claims are still under review. 

“You know there are people who are saying SHA is not paying them. We have contracted over 10,272 public, private and faith-based facilities across the country. We have paid close to Sh13 billion for primary healthcare alone,” Duale said.

The CS said SHA has also paid close to Sh75 billion under the Social Health Insurance Fund (SHIF), Sh3.5 billion under the Public Servants Medical Scheme, and about Sh1 billion for emergency, chronic and critical illness funds.

“This month alone, SHA has paid close to Sh6 billion. The law allows us a window of 90 days to pay after review, verification and forensic audit. We pay on the 14th of every month, and SHA has enough money in its bank accounts,” he said.

However, Duale emphasized that the authority would not compromise accountability. “We will not pay for fictitious claims that Kenyans have not received,” Duale said.