Healthcare providers across the country have received a major boost after the Social Health Authority (SHA) announced the start of payments for verified claims of Ksh10 million and below inherited from the defunct National Health Insurance Fund (NHIF).
In a notice issued on Tuesday, August 12, SHA said the first batch of payments has already been processed, marking the beginning of a long-awaited settlement program for thousands of healthcare providers that have been waiting for reimbursement of historical claims.
The authority said the payments will be made in four batches and that the first group of beneficiaries has already been uploaded on its website.
SHA added that healthcare providers whose claims require further clarification may be contacted and asked to provide additional documents before their payments are finalized.
Healthcare providers have for months raised concerns over delayed reimbursements, saying the outstanding claims had strained their operations and affected service delivery in some facilities.
The move is a significant step in the government’s efforts to clear debts accumulated under the NHIF before it was replaced by SHA as part of Kenya’s new healthcare financing system.
SHA Begins Settlement Process
The latest announcement follows an earlier government decision to release Ksh4 billion to settle verified NHIF claims worth Ksh10 million and below.
Before payments began, SHA carried out a nationwide verification and sign-off exercise requiring healthcare providers to confirm the amounts validated by the authority.
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Facilities were also given an opportunity to raise concerns or seek clarification on verified claim amounts before payments were processed.
The exercise targeted 3,527 eligible healthcare providers across the country, including hospitals, clinics, health centers, nursing homes, dispensaries and other medical facilities.
According to SHA, providers who completed the verification and sign-off requirements successfully are now being considered for payment under the phased settlement program.
The authority said the release of the first batch demonstrates progress in addressing one of the most contentious issues inherited from the transition from NHIF to SHA.
While payments for claims of Ksh10 million and below have started, SHA is also pursuing the settlement of larger claims exceeding the Ksh10 million threshold.
The authority has already begun surveillance and verification of claims above Ksh10 million, which involve hundreds of healthcare facilities across the country.
SHA has indicated that additional funding support from the National Treasury will be required to facilitate payment of the larger claims during the current financial year.
The authority maintains that all claims must undergo a strict verification process before payments are approved in order to safeguard public funds and ensure only legitimate claims are settled.
Mounting Challenges for SHA
SHA begins the payments amid mounting scrutiny over its relationship with healthcare providers.
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In May, senators criticized the authority over delayed reimbursements, rejected claims, and persistent system failures, arguing that many public hospitals were facing severe financial strain despite SHA reporting a 79 percent claim settlement rate.
SHA told the Senate it had disbursed KSh139.5 billion under various health financing schemes, but lawmakers said hospitals were still struggling with cash flow challenges linked to delayed payments.
As of April 30, 2026, hospitals and clinics had submitted claims worth KSh181.9 billion under the scheme.
The authority has also faced disputes with some private and faith-based healthcare providers over reconciliation agreements, with providers questioning reimbursement figures and unexplained deductions.
The settlement of NHIF legacy claims therefore comes as SHA seeks to address longstanding concerns over outstanding payments and rebuild confidence among healthcare providers.
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