Health Cabinet Secretary Aden Duale has defended the pace of hospital payments under the Social Health Authority, warning that the government will not release money for fictitious claims.
Speaking in Garissa town during a graduation ceremony at Madarasa Munawar on Sunday, where he was the chief guest, Duale dismissed claims that the government was dragging its feet in settling hospital bills.
“We will only pay after we do due diligence. SHA will conduct due diligence, forensic audits and clinical reviews to make sure that the services you have offered are the right ones and that the Kenyan patient has actually received them,” Duale said.
He explained that hospitals complaining of non-payment are largely those whose claims are still under review.
The CS said the Health Ministry has so far paid close to Sh13 billion for the Primary Healthcare Fund under SHA.
“You know, there are people who are saying, SHA is not paying them. We have contracted over 10,272 public, private and faith-based facilities across the country. We have paid so far for primary health care close to 13 billion,” Duale said.
“For the Social Health Insurance Fund, we have paid close to 75 billion. And for the public medical scheme, we have paid close to Sh3.5 billion.”
Under the Public Officers Medical Scheme, he said the state has paid out Sh3.5 billion, with Sh1 billion paid to the Emergency, Chronic and Critical Illness Fund.
He added that the law requires payments to hospitals to be made within three months after verification.
“The law allows us that we must pay within 90 days upon verification, review, validation and forensic audit. We pay every month on the 14th, and this month alone, we have paid close to Sh6 billion, and SHA has enough money in its bank account,” he remarked.
“But we will not pay for fictitious claims that Kenyans have not received.”
To ensure prudent stewardship of public resources, he says that transparency and accountability remain key to the settlement of claims by medical facilities.
"We will continue to engage openly with stakeholders, provide timely updates and uphold the highest standards of integrity as clinical reviews progress and outstanding claims are settled in accordance with the law," he said.
