Doctors Reject New Govt Proposal on Insurance Claims
According to the union, even though the proposal aims to ensure transparency in the Social Health Authority (SHA), several factors makes it unsustainable...
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Doctors in Kenya, represented by the Kenya Medical Practitioners, Pharmacists and Dentists' Union (KMPDU), have rejected a new government proposal that would introduce time-based pre-authorization restrictions on insurance claims. This comes after Health Cabinet Secretary Aden Duale suggested that the Social Health Authority (SHA) and Digital Health Authority (dha) might reject claims pre-authorized outside official working hours of 8 AM to 5 PM.
- The KMPDU stated the proposal is "Operationally unrealistic and administratively arbitrary" due to inadequate staffing and heavy workloads.
- The union highlighted issues such as insufficient staffing, delayed remuneration, and lack of incentives as reasons the current healthcare system cannot support such restrictions.
- CS Duale had previously announced a crackdown on doctors allegedly working in private clinics during public hospital hours, accusing them of fraud.
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CS Duale Orders Hospital Probe and Exposes C-Section Scheme Amid Insurance Disputes - December 2025
Health Cabinet Secretary Aden Duale has ordered new investigations into Sisto Mazzoldi Hospital following an NTV exposé alleging fraudulent insurance claims. Duale directed the Kenya Medical Practitioners and Dentists Council (KMPDC) to immediately investigate, with strong disciplinary action promised if malpractice is confirmed. The CS also exposed a concerning rise in unnecessary Caesarean section deliveries, which he stated are driven by financial incentives from the Social Health Authority (SHA). In a related development, doctors represented by KMPDU have rejected a new government proposal that would introduce time-based pre-authorization restrictions on insurance claims. The proposal suggested that the Social Health Authority might reject claims pre-authorized outside the official working hours of 8 AM to 5 PM.
