Gov’t reaffirms commitment to free primary healthcare, payment of valid NHIF claims

The government has reaffirmed its commitment to providing free primary healthcare services in all public health facilities nationwide and clearing outstanding claims under the now-defunct National Health Insurance Fund (NHIF).

In a statement, the Social Health Authority (SHA) assured Kenyans that registered members can access free primary healthcare services at government facilities without restrictions.

The authority stated that it has contracted 8,600 healthcare providers to ensure accessibility, with a full list available on the its website and Huduma Centers.

SHA disclosed that it has disbursed Ksh5.1 billion this week, bringing the total payouts since October 2024 to Ksh18.29 billion.

Additionally, primary healthcare facilities have received Ksh1.3 billion under a new capitation model, with 51% allocated to private providers.

The health authority also addressed concerns over NHIF debt, stating that Ksh10 billion out of Ksh19 billion in undisputed claims has already been settled.

“SHA is working with healthcare providers to finalize NHIF pending claim reconciliations, which are currently 60% complete. Healthcare facilities must provide proof of archived claims to facilitate verification before payments are processed,” SHA stated.

To enhance efficiency in claims processing, SHA further announced nationwide training on the PHC reimbursement model starting February 27, 2025 urging healthcare providers to submit their financial returns promptly to facilitate timely payments.

SHA clarified that the government does not owe private facilities Ksh30 billion as earlier reported.

“We wish to clarify that the Government does not owe RUPHA Kes 30 billion, as asserted. RUPHA facilities will receive training on claim management to improve the accuracy of claim submissions and prevent delays.  RUPHA facilities have been trained on accessing claims through an online dashboard, enabling them to track their payments efficiently.”