Health CS Aden Duale has formed a committee that will vet the pending bills emanating from the now moribund National Health Insurance Fund (NHIF).
The Committee is tasked with scrutinizing and verifying NHIF medical claims submitted between 1st July 2022 and 30th September 2024. It will also advise the Ministry on the settlement of verified claims.
NHIF was disbanded by President William Ruto and replaced by the Social Health Authority (SHA).
Dubbed the NHIF Pending Medical Claims Verification Committee, the 18-member team will be scrutinizing outstanding medical claims and providing recommendations on their validity.
They will be required to discharge the mandate within 90 days.
According to a special issue of the Kenya Gazette dated March 28, 2025, the committee will be chaired by James Masira Ojoo, with Dr Anne Wamae as vice-chair.
The secretariat will be headed by Peter Kibedu and supported by Susan Mbogoh, Dr Chemutai Ogoyi, Dr Emmanuel Ayodi Ludigi, Hillman Yusuf, and Elibet Kituyi
Members of the committee include Edward Kiprono Biwott, Mehsack Mlampe, Yabesh Awele Arwet, Tom Nyakiba, Catherine Karuri Bosire, Paul Waire, Peter Githaiga Mungai, Jacqueline Masha, Dr Judith Anyango and David Owino.
The team will establish clear criteria for examining claims, identify anomalies or fraud in submitted claims, prepare reports and policy recommendations to relevant government agencies and recommend measures to prevent future claim irregularities.
“They will undertake research and consultations as needed and submit a detailed report to the Ministry of Health with settlement proposals,” the Gazette Notice stated.
“The team is also expected to assess claims-related data from various NHIF-accredited facilities and may consult any stakeholder or expert to fulfill its mandate.’’
