Health Cabinet Secretary Aden Duale on Saturday constituted a new committee to address the impasse facing the health sector regarding the pending bills that the defunct National Hospital Insurance Fund(NHIF) owed to medical facilities.
In an announcement published in a special gazette, Duale announced that the committee would address the backlog of unsettled medical claims that has threatened to cripple the sector especially with complaints from the private and mission based hospitals.
''It is notified for general information of the public that the Cabinet Secretary for Health has constituted a Committee to be known as the National Health Insurance Fund (NHIF) Pending Medical Claims Verification Committee (hereinafter referred to as 'the Committee'),'' read part of the notice by Duale.
James Masiro Ojee will chair the committee, which will consist of eighteen other members who will scrutinize all pending claims accumulated between July 1, 2022, and September 30, 2024.
According to Duale, who recently took over the reins at Afya House, the committee will also assist the government in establishing a clear framework to determine the validity of the pending bills.
Further, it will make recommendations on the settlement of genuine claims while identifying and flagging any fraudulent or irregular submissions for appropriate action.
Additionally, the committee will propose long-term reforms to prevent future claim backlogs, ensuring a transparent, accountable, and efficient claims process.
''Establish a clearly defined criteria for detailed examination and analysis of such pending medical claims to determine the genuineness of each or otherwise,'' the notice added.
''Make recommendations to the Ministry of Health on the necessary actions to be taken for satisfactory disposal or settlement of the identified pending medical claims.''
The members of the committee include Edward Kiplimo Bitok, Meshack Matengo, Meboh Atieno Awour, Tom Nyakaba, Catherine Karori Bosire, Paul Wafula, Catherine Mungania, James Oundo, Jackline Mukami Njiru, Judith Awinja (Dr.), and David Dawe.
The secretariat will be led by Peter Kitheka as its head, with support from Shawn Mogaka, Consolata Ogot (Dr.), Emmanuel Ayodi Lusigi (Dr.), Halima Yussuf, and Wilbert Kurgat.
However, legal experts raised questions over the legality of the committee, arguing that its fate could likely follow a suit where the High Court, on March 6, suspended President William Ruto's task force on health audit.
In the ruling, Justice Bahati Mwamuye declared the Presidential Task Force on Health Audit unconstitutional, stating that it had unlawfully usurped the role of the Kenya Human Resources Advisory Council, rendering its formation and operations illegitimate.
