Healthcare facilities with large unpaid claims from the defunct National Hospital Insurance Fund (NHIF) have been placed under a new review by the Social Health Authority (SHA), which is checking claims worth Sh10 million and above before the government moves to the next stage of settling the debts.
SHA has started surveillance and verification of the outstanding claims as it prepares for the planned payments in the 2026/27 financial year.
The authority has issued a schedule showing the claims covered by the exercise and asked healthcare providers to go through it and ensure they have all the documents needed for the review.
In a notice, SHA said the latest process would focus on pending NHIF claims valued at 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.
Healthcare providers whose claims are listed have been advised to prepare the required records so that the verification can be carried out without delays.
The exercise is part of the wider process of dealing with unpaid bills left behind after NHIF was replaced by SHA under the new health insurance system.
SHA had earlier said it was looking to the National Treasury for funding in the 2026/27 financial year to clear verified claims above Sh10 million owed to each healthcare facility.
According to the authority, the request covers 451 healthcare facilities. SHA said the claims involved had already passed through the required verification process.
The new exercise will now concentrate on the claims contained in the latest schedule as the authority works towards the next step in settling the outstanding amounts.
Providers have therefore been asked to ensure that their supporting documents are available whenever their claims are presented for review.
The move follows the government’s release of Sh4 billion in July to start paying healthcare facilities with verified debts from the former NHIF.
That payment programme dealt with a different group of claims. SHA said the Sh4 billion was meant for verified claims worth Sh10 million and below, benefiting 3,527 healthcare facilities across the country.
Before those payments could be made, SHA organised a countrywide sign-off exercise for the facilities that qualified.
The healthcare providers were required to sign agreements confirming that their verified claims from the former NHIF had been cleared in full.
“Eligible healthcare facilities will be required to execute sign-off agreements confirming that their verified defunct NHIF claims have been fully settled,” SHA said.
To support the process, the authority sent teams to its county offices to help healthcare providers with the required paperwork and coordinate the sign-off exercise.
SHA said completing the sign-off process would allow payments to be released to the eligible facilities.
The exercise was carried out in stages, with facilities from different counties directed to specific regional stations where they could complete the process.
The authority also said the list of the 3,527 facilities covered by the earlier payment programme was available through its website and county offices.
Separate from the Sh4 billion payment, SHA had disclosed plans to seek Treasury funds for the larger claims exceeding Sh10 million for each facility.
That request covers the 451 healthcare facilities whose claims fall within the higher-value category.
The latest verification is now bringing those claims into focus as SHA continues with efforts to confirm and prepare the outstanding NHIF liabilities for settlement.