Selected Level 4 hospitals face verification of outstanding NHIF claims under a revised SHA schedule.
Facilities with outstanding NHIF claims of Sh10 million or more must check their revised verification dates and prepare supporting documents.
The Social Health Authority (SHA) has changed verification dates for selected Level 4 hospitals with unpaid NHIF claims. The affected facilities have inherited claims from the defunct National Hospital Insurance Fund (NHIF). In a notice issued on Monday, SHA CEO Dr Mercy Mwangangi said the surveillance and verification visits had been rescheduled. The exercise targets facilities with outstanding NHIF claims of Sh10 million or more. Meanwhile, hospitals must check the revised programme and prepare documents supporting their claims.
Hospitals Directed to Check New Dates
The rescheduling follows an earlier SHA notice dated September 18, 2026. That notice listed facilities selected for the verification exercise. According to SHA, the updated list and visit schedule are available on its website. The Authority said the changes give affected providers more time to prepare. Therefore, hospitals should confirm their new dates before verification teams arrive. Providers seeking clarification can contact SHA’s Benefits and Claims Directorate.
Verification Targets Outstanding Claims
The exercise forms part of the government’s process of reconciling inherited NHIF medical claims. Verification will help establish whether submitted claims are accurate and valid before payment. The Ministry of Health has previously said the process involves reviewing hospital records and confirming billed services. Additionally, officials check compliance with financial and audit requirements. In April 2025, the ministry established a committee to review pending NHIF claims submitted between July 1, 2022, and September 30, 2024. The committee also received a mandate to recommend settlement of claims that pass verification.
The government has adopted a phased approach to the inherited liabilities. Claims worth Sh10 million and below have already undergone reconciliation and sign-off in several facilities. However, larger claims remain under review as the verification process continues.
Government Pays Verified Claims
By August 2026, the Ministry of Health said 3,526 facilities had completed reconciliation for claims worth Sh10 million and below. Of those facilities, 3,058 had received payments totalling Sh3.63 billion. Meanwhile, Health Cabinet Secretary Aden Duale told the Senate in April that the government had allocated Sh4 billion for verified NHIF claims. The allocation particularly targeted claims ranging from zero to Sh10 million.
According to Duale, the funding would help rebuild confidence among healthcare providers. It would also support the transition from NHIF to SHA. For now, the rescheduled Level 4 hospital visits continue the wider reconciliation process. Hospitals must therefore provide supporting records before SHA can determine whether outstanding claims qualify for settlement.
