Health Cabinet Secretary Aden Duale has stated that the Ministry of Health will respect a recent court ruling that declared the National Health Insurance Fund (NHIF) Pending Medical Claims Verification Committee unconstitutional. However, in a statement released on Thursday, August 14, Duale was quick to add that the principle of verification would remain non-negotiable, and due process would be followed in settling the bills.
The ruling, which was delivered by the High Court in Eldoret on Wednesday, August 13, nullified the creation of the committee, terming it illegal. In his ruling, Justice Reuben Nyakundi stated that the committee's formation went against Article 31 of the Constitution when read together with the Social Health Authority Act. The court determined that there was no legal basis for the establishment of such a committee, as the transitional provisions of the Social Health Insurance Act do not provide for the formation of any committees to establish the liabilities of the NHIF.
Despite the court's decision, CS Duale has made it clear that the ministry's commitment to accountability and transparency remains unwavering. In his statement, he noted that while the structure of the committee might have to change, the principle of verifying pending claims would still be upheld. "The Ministry of Health under my leadership will uphold and respect the decision of the court but we shall be guided by the same constitutional provision of articles 223, 206(1)(b), public finance management Act 2012, public procurement and Asset Disposal act 2015, Appropriations act, Anti corruption and Economic crimes act, parliamentary oversight on how the NHIF pending bills will be settled," he stated.
Duale's statement is a powerful message to both the healthcare providers and the public that the government is serious about protecting public resources. He added, "Verification of the pending claims is not negotiable and we shall protect public resources. We shall consult on how the verification will be down in accordance with the supreme law of the land." This indicates that while the specific committee may have been dissolved, the ministry will find a new, legally sound way to scrutinize all pending claims.
The now-defunct committee was formed earlier in the year to address the backlog of unsettled medical claims that had accumulated between July 1, 2022, and September 30, 2024. Its primary task was to scrutinize all claims, evaluate their legitimacy, and make recommendations on the settlement of genuine submissions while flagging any fraudulent or irregular ones for appropriate action. The court's ruling, therefore, while a legal victory for the petitioners, has created a new challenge for the Ministry of Health, which must now find a new mechanism to achieve the same goal.
