The Social Health Authority (SHA) will next month reveal the list of foreign hospitals accredited to provide medical services to Kenyans, with partial costs covered under its scheme. The announcement comes amid ongoing efforts to finalise procurement procedures, which have delayed accreditation since SHA replaced the National Hospital Insurance Fund (NHIF).
SHA CEO Mercy Mwangangi told the National Assembly Public Investments Committee on Social Services, Administration and Agriculture that the authority will pay a maximum of Sh500,000 per patient for treatment abroad. She explained that the delay arose because the new system requires a full procurement process, unlike the previous NHIF arrangements.
“The NHIF had a different contractual agreement with the service providers, but now we have to follow the entire procurement process while contracting the facilities,” Mwangangi said.
She added that once the process is complete, SHA will publish the names of accredited hospitals in countries such as India, Turkey, and Germany, ensuring transparency for Kenyans seeking treatment overseas.
Addressing concerns about fraudulent claims under NHIF, Mwangangi said the new approach is designed to prevent payments for services that were never provided. The authority has already invited eligible foreign hospitals to submit bids, including those with pending NHIF bills.
“This is not closed, it is open, and even those facilities that we currently have their pending bills from NHIF are allowed to bid again,” she said.
Machakos Town MP Caleb Mule pressed the authority on assisting Kenyans already admitted abroad. Mwangangi clarified that SHA cannot pay any bills until formal contracts are in place.
“What is it going to take to pay all their claims? Because we have relatives who are suffering in those hospitals,” Mule asked.
“Without any contractual agreement under SHA with the foreign hospitals and before payment of pending bills amounting to Sh146 million owed to the facilities contracted by NHIF, we cannot pay for patients now,” Mwangangi responded.
Committee chair MP Emmanuel Wangwe urged the authority to expedite hospital procurement to cover Kenyans already receiving treatment overseas.
“For Kenyans that are already out, procure those hospitals within the law because you can fall sick anytime you’re abroad,” he said.
Mwangangi described the initial challenges during the transition as expected but said the changes are strengthening the health system.
“SHA has so far paid Sh131 billion to hospitals. I want to assure all Kenyans we are determined to offer better healthcare in this country,” she said, noting that the new system has detected Sh1.8 billion in fraudulent claims from some hospitals.
“I want to assure Kenyans that all their contributions to SHA are safe,” Mwangangi added.
Last year, Health Cabinet Secretary Aden Duale indicated that the government would tighten oversight of overseas medical referrals, suspending the programme until new rules were in place. Under these regulations, only treatments unavailable in Kenya will be funded, as many procedures previously sought abroad—such as advanced imaging, kidney transplants, open-heart surgeries, and joint or spinal treatments—are now available locally.
