SHA Changes System After Flagging Claims Worth Ksh 3B
CS Duale has been on a nationwide campaign to implore Kenyans to register for the scheme...
✨ Key Highlights
The Social Health Authority (SHA) has mandated several hospitals to provide supporting documents within 15 days for over Ksh3 billion in flagged claims, beginning September 16. This initiative aims to enhance transparency and combat fraud within the Kenyan government healthcare system.
- Over Ksh3 billion worth of claims were flagged, primarily due to insufficient documentation such as itemized invoices and discharge summaries.
- The SHA, led by CEO Mercy Mwangangi, is implementing a new Missing Documents Resubmission Module on its provider portal to facilitate compliance.
- Hospitals have a 14-day window to resubmit missing documents, with claims not submitted within this timeframe automatically transitioning to 'rejected' status after September 30.
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SHA Flags Ksh3B in Claims; KMPDC Bans Hospitals From Detaining Bodies Over Bills - September 2025
The Social Health Authority (SHA) has mandated several hospitals to provide supporting documents within 15 days for over Ksh3 billion in flagged claims to combat fraud. This action follows a heated exchange between Health Cabinet Secretary Aden Duale and Kenya Medical Association President Simon Kigondu concerning SHA's debt and fraud prevention measures. Kigondu criticized the authority's accumulated debt, while Duale defended the Practice 360 App as a tool to prevent fraud. Separately, the Kenya Medical Practitioners and Dentists Council (KMPDC) has declared that hospitals have no legal right to detain the bodies of deceased patients over unpaid medical bills. This ruling came after a man complained to the Office of the Ombudsman about a hospital unlawfully holding his wife's body.
