Faith Based Health Service providers under the umbrella of the Kenya Faith Based Health Services Consortium (KFBHSC) have intensified efforts to have the Government settle pending NHIF, MAKL and SHA claims totalling Ksh13B.
During a meeting with Health Cabinet Secretary Aden Duale and top MOH officials, faith-based health service providers CHAK, MEDS, KCCB and SUPKEM demanded payment of Ksh6 billion claims from NHIF, Ksh1 billion from MAKL and Ksh6.25 billion from SHA. They asked the Government to ensure predictable SHA claims payment schedules for better planning to ensure continuity of services.
Data collected from a sample of 58 CHAK member health units shows that slightly above 50 per cent of claims approved by SHA have been paid. The lowest paid health facility received 38 per cent of its approved SHA claims while the highest paid received 70 per cent. Only 20 per cent of claims from the sampled health facilities had been rejected by the SHA system, while a huge proportion of 80 per cent of claims made to SHA by the health service providers were consistent with invoices and had been approved. The FBOs demanded improvement in SHA payment rates of approved claims to at least 70 per cent.
Responding to the demands by the FBOs, the Ministry of Health team which also included PS Medical Services Dr Ouma Oluga, SHA CEO Dr Mercy Mwangangi, KMPDC CEO Dr David Kariuki and Digital Health Authority CEO Anthony Lenaiyara committed to clear the pending claims.
Health CS Duale said he had written to the National Treasury to release Ksh5.3 billion to clear NHIF claims and promised to raise the MAKL debts with the Cabinet Secretaries for Interior and Education. He added that due process would be followed in settling the claims.
Duale pledged that SHA would up payment of approved claims from the current 62.6 per cent to 70 per cent for FBOs. According to the Health CS, Ksh577 million had been dispatched to health facilities at the end of September 2025. He committed that SHA would pay health facility claims by the 14th of every month moving forward with payments made within the 90 days provided for in the law. The Health Authority would also introduce an aging analysis to track the commitment to pay within 90 days.
The faith-based health service providers had sought audience with the MOH to address challenges with the Government health financing mechanisms. They cited massive rejection of SHA claims with a very narrow window for redress, leading to many claims being time barred. Inordinate delay of payments for surgical cases had led to near paralysis of the operations of Level 4-6 hospitals.
The FBO consortium also expressed disappointment with the procedure used by the KMPDC to downgrade health facilities which they said was not preceded by inspection to confirm bed capacities of affected health facilities. In some cases, KMPDC did not provide reasons for down grading the health facilities.
Additionally, KMPDC did not recognise beds in Level 2 facilities, yet the CS Health had acknowledged they were offering delivery services for pregnant mothers. According to the FBOs, the process of registration and inspection of health facilities by KMPDC was lengthy, hindering onboarding of facilities to SHA.
The FBOs demanded that KMPDC conduct prior joint inspections with them before downgrading health facilities and once improved, reinstate them within the shortest time possible.
However, KMPDC said it would continue conducting independent inspections using a standard checklist. The Council said most health facilities were downgraded due to inadequate infrastructure and pledged to share updated inspection guidelines as soon as they were ready.
Of the 58 health facilities surveyed, 58 per cent said they had experienced challenges with the SHA provider portal. Among the challenges they had experienced were system unreliability and performance, biometric authentication, preauthorization and claims issues and user support gaps.
While appreciating Government support of 100 ICT gadgets towards digital superhighway connectivity, the FBO consortium noted that these were inadequate for supporting digitization of health services and asked the Government to issue health facilities with ICT and biometric gadgets to improve coverage of SHA services.
The health CS promised to issue SUPKEM health facilities, which had not benefitted in the last distribution, with 20 ICT gadgets and asked the consortium to submit a list of health facilities in remote areas for possible future support. This would align with the original UHC plan of supporting GOK and FBO health facilities with ICT gadgets to support digitization of health services in the country.
CHAK hospitals also raised concerns on SHA claims reimbursement during the CEOs’ Forum held at CHAK Guest House and Conference Centre and during a sitting with the Parliamentary Health Committee.