NHIF Under Scrutiny: CS Duale Launches Task Force to Audit Sh33 Billion in Claims

Health Cabinet Secretary Aden Duale has inaugurated a high-powered task force to audit over KSh33 billion in pending claims owed by the National Health Insurance Fund (NHIF), a move expected to clean up decades of financial mismanagement in Kenya’s public health sector.

The unveiling of the 19-member committee took place at Afya House on April 7, 2025, and follows a presidential directive aimed at restoring transparency, streamlining claim verification, and enhancing accountability in national health financing.

The Task Ahead: 90 Days, Sh33 Billion

Chaired by James Masiro, the task force comprises professionals from the private sector, county governments, and the Social Health Authority (SHA). Their mandate? To investigate claims submitted between July 1, 2022, and September 30, 2024, and distinguish genuine medical bills from exaggerated or fraudulent submissions.

“The President has directed immediate settlement of all verified claims below Sh10 million, which represent 91% of the pending bills. The remaining 9%, involving claims above Sh10 million, will be cleared within the 90-day period,” CS Duale announced.

Deep Dive into a Broken System

The task force is expected to uncover systemic issues in the claim verification process. According to CS Duale, the focus will be on:

• Services offered without valid contracts
• Health facilities operating beyond approved capacity
• Doctors billing outside their specialization
• Inflated receipts and tariffs
• Duplicate records and unsupported surgeries
• Suspected data or system manipulation

“Some bills originate from non-existent facilities. Others involve unwarranted hospital stays. We must stop this bleeding,” said Duale, emphasizing that only legitimate claims will be paid.

Public Trust on the Line

Accompanied by senior officials including PS Mary Muthoni, Health Director General Dr. Patrick Amoth, and SHA board members, Duale stressed the urgency of the mission. “This committee must operate with utmost integrity. We are taking a bold step to restore public confidence in our health system.”

Task force chair James Masiro acknowledged the magnitude of the assignment. “This is a massive task, but we are fully committed. We understand the sensitivity of this process and will act professionally to earn public trust,” he said.

Masiro added that the team will submit regular progress reports and remain in close contact with the Ministry of Health to ensure a smooth and transparent process.

What This Means for You

The NHIF audit comes at a time when Kenyans continue to struggle with accessing quality healthcare. With the recent rollout of the Social Health Insurance Fund (SHIF) still facing teething problems, this cleanup of pending claims could be the first step toward a more efficient and transparent public health system

In other news:ODM Leaders Urge Muturi to Present Corruption Evidence Against Ruto to Authorities

NHIF Under Scrutiny: CS Duale Launches Task Force to Audit Sh33 Billion in Claims