Health CS Duale announces new committee to crack down on SHA fraud

In a statement after meeting with the health insurance CEOs at Afya House, CS Duale announced that the committee would ensure that every Kenyan can access quality healthcare while taming ill practices.

“We agreed to establish a Joint Anti-Fraud Action to crack down on malpractice in the sector and strengthen collaboration with the Social Health Authority (SHA) to expand access to affordable, quality healthcare for all Kenyans," Duale stated.

"I updated the CEOs on the ongoing Taifa Care reforms anchored in the Social Health Insurance Act, Primary Health Care Act, Digital Health Act, Facility Improvement Financing Act and the forthcoming Quality of Care and Patient Safety Bill, all critical pillars in advancing Universal Health Coverage (UHC)."

Some of the resolutions agreed upon in the meeting include having private insurers extend benefits beyond SHA’s packages and co-finance chronic care, insurers to be linked with SHA’s digital claims platform to ensure transparency and efficiency, and accreditation being harmonized to ensure quality of care is uniform.

The CEOs also rallied for support to strengthen the National Health Registry and establish a framework to regulate drug pricing.

Furthermore, Duale reaffirmed the Ministry’s commitment to tackling structural challenges and called for a collaborative framework.

“I reaffirmed the Ministry's commitment to tackling structural challenges through legal, institutional and data-driven reforms and called for a Public–Private Collaborative framework involving MoH, SHA, private insurers and IRA,” reaffirmed Duale.

The health coverage was introduced on October 1, 2024 to replace the National Health Insurance Fund (NHIF).

President William Ruto said NHIF accumulated billions of shillings in debt and had misalignments with the contributions from Kenyans in comparison to the cost of healthcare services.

President Ruto also promised that SHA would rid the healthcare sector of problems associated with NHIF, although recent adaptations of biometrics and bed-sharing fraud by healthcare facilities are proving challenging to ailing Kenyans.