The chairperson of the Social Health Authority, Mohammed Abdi, has announced that Ksh17.5 billion Social Health Insurance Fund (SHIF) claims dating back to October last year have been settled.
Speaking in an interview on NTV, the chairperson insisted that the only unresolved payments are related to the National Health Insurance Fund (NHIF) but as far as SHA is concerned, there are no pending debts
"Under the claims that we have received from SHIF, which under SHA, is Ksh 17.5 billion and we have paid it all, that is from October 2024 to January 2025. Meaning, despite our contract with the providers saying we will settle claims within the 90-day period, we have been able to do on a monthly basis," Abdi stated.
He revealed that in 2018, a task force of a panel of experts was formed to identify the challenges faced by NHIF and how to fix the problems adding that the only issue affecting NHIF was sustainability.
He further explained that SHA inherited NHIF's both liability and sustainability.
Abdi noted that the need for monthly disbursements was influenced by the pending bills inherited from NHIF and that facilities need cash flow to continue to settle the pending bills.
"We got Ksh30 billion and out of that, Ksh9 billion to Ksh10 billion is for work injury benefits insurance and that should be the co-mandate, that should have gone somewhere else because that is not equipped and it was a co-insurance with private insurance," Abdi stated.
He added that members are owed Ksh30 billion but stated that Ksh9 billion was settled from July to mid-October 2024 explaining that he had no shares or equity in any hospital.
Abdi made the clarification after the Rural and Urban Private Hospital Association (RUPHA) suspended the use of SHA service beginning Monday, February 24.
RUPHA, on Thursday, stated that this was the last resort to force the government to improve the services being offered under SHA.
Their demands were a settlement of Ksh30 billion owed to the hospitals accumulated under the old National Health Insurance Fund (NHIF) since 2017.
RUPHA noted that despite the government's promise to clear the payments, hospital services will not continue unless the debt is cleared.
