CS Aden Duale approves 8 foreign hospitals for SHA referrals

Health Cabinet Secretary Aden Duale said the overseas treatment package has been capped at Ksh.500,000 and will only apply to procedures that are not available locally.

After months of contestation over the suspension of the benefit, the government confirmed the resumption of the overseas referral package, with eight facilities already empanelled.

“So far we have eight groups of hospitals that are now going to be accessible overseas to Kenyans next week. The process of enrolling hospitals for overseas treatment is continuous. We will be using an SPP procedure and this list will be changing as more and more providers apply," SHA CEO Mercy Mwangangi stated,

Duale reiterated that SHA will only cover treatment abroad under strict conditions.

“SHA will only pay for overseas treatment if the procedure is not available locally. We have capped the maximum payable amount for these overseas treatments at Ksh.500,000,” Duale noted. 

He added that all approved overseas facilities must be formally linked to local contracted hospitals to ensure continuity of care once patients return to Kenya.

Speaking during a Senate retreat in Naivasha, Duale dismissed claims that the authority had lost billions of shillings through fraudulent claims.

“I wish to categorically state that there has been no loss of Ksh.11 billion from the Social Health Authority. This figure, which currently stands at Ksh.12.7 billion as of today, represents claims that were flagged, rejected, and unpaid by our new digital gatekeeper. Therefore, this represents money saved, not lost,” stated Aden Duale, Health Cabinet Secretary.

Meanwhile, in Nairobi, a suspect linked to SHA fraud was arraigned in court facing multiple charges.

Harun Liluma is accused of conspiracy to defraud and operating an unlicensed health facility, among other offences.

According to court documents, Liluma and others not before the court allegedly accessed the Kenya Medical Practitioners and Dentists Council regulatory Human Resource Information System and altered records.

He is further accused of unlawfully registering several health facilities that did not meet statutory requirements, enabling them to fraudulently receive over Ksh.12 million from SHA.

The court released him on a cash bail of Ksh.4 million as investigations continue.