The Ministry of Health has announced the formation of the National Health Insurance Fund (NHIF) Pending Medical Claims Verification Committee, tasked with auditing and resolving a backlog of unsettled medical claims dating between July 1, 2022, and September 30, 2024.
In a gazette notice dated March 28, 2025, Health Cabinet Secretary Aden Duale appointed James Masiro Ojee as Chairperson and Dr. Anne Wamae as Vice Chairperson.
The 18-member team includes medical and policy experts, among them Edward Kiplimo Bitok, Meboh Atieno Awour, Dr. Judith Awinja, and Catherine Mungania. The Secretariat will be led by Peter Kitheka.
Mandate of the Committee:
• Scrutinize all pending NHIF medical claims for the stated period.
• Establish a verification criteria to determine the legitimacy of each claim.
• Recommend action on verified claims, including settlements.
• Flag any fraudulent or corrupt claims for prosecution.
• Propose reforms to prevent future claim backlogs.
The committee will also have access to previous reports, regulate its own procedures, conduct necessary studies, and may co-opt additional members in consultation with the CS.
The Secretariat is tasked with maintaining accurate records, facilitating research, and liaising with relevant agencies to collect data needed to fulfill the committee’s mandate.
The team will operate from the Social Health Authority Building and is expected to play a key role in restoring trust in NHIF processes, while ensuring efficient and corruption-free handling of public health funds.
