Health Cabinet Secretary Aden Duale has dismissed reports that the Social Health Authority (SHA) lost KSh11 billion, saying the money in question was not lost but blocked over suspected fraudulent claims.
Speaking on Friday during an Assessment and Planning Retreat with Senators, Duale said the narrative around the alleged loss was misleading and needed to be corrected.
“Speakers and senators, we must confront the narrative of the alleged loss of KSh11 billion. I want to categorically state that there is no loss of the KSh11 billion in SHA,” he said.
According to the CS, the amount has since risen to KSh12.7 billion as of late February 2026. He explained that the figure represents claims that were flagged, rejected or left unpaid by SHA’s digital verification system.
“This figure currently stands at KSh12.7 billion. These are claims that were flagged, that we rejected and left unpaid by our digital superhighway gatekeeper,” Duale told the senators.
He argued that under the former National Hospital Insurance Fund (NHIF), which relied largely on manual processing, some of the claims could have gone through and been paid.
Duale said he is ready to table detailed data before the Senate to show how much of the rejected KSh12.7 billion came from private hospitals and how much originated from public facilities. He maintained that some of the claims were blocked due to suspected fraud.
“I will give you data which shows how much is from the private sector and from public hospitals,” he said.
At the same time, the CS gave an update on SHA’s performance. He said that as of late February 2026, about 29.7 million Kenyans had registered under the new health scheme.
He added that SHA had collected KSh142.78 billion in contributions and paid out KSh105 billion to healthcare providers across the country.
According to Duale, the authority is currently settling an average of 73 per cent of claims across private, public and faith-based health facilities.
“We are achieving an average claims settlement rate of 73 per cent across the board,” he said.
The CS maintained that the new digital system is meant to seal loopholes and ensure only genuine claims are paid, even as debate continues over the transition from NHIF to SHA
