The Social Health Authority has paid out KSh 27.91 billion to 8,349 county government health facilities out of KSh 40.91 billion in claims received as at 30 June 2026, the Authority said in a press statement.
According to SHA, KSh 6.96 billion was under review, KSh 1.97 billion had been returned to facilities for correction, KSh 646.2 million was pending supporting documents, while KSh 3.43 billion was rejected for not meeting benefit or contractual requirements.
The Authority said it had settled about 80 per cent of the claim value that completed adjudication, with the average county settlement rate at 80.5 per cent.
Tana River recorded the highest rate at 87.0 per cent, followed by Laikipia at 86.1 per cent, and Baringo and Siaya at 85.4 per cent each.
“Claims must meet verification standards before funds are released,” SHA said.
Which counties received highest claims pay from SHA?
In addition, the authority noted that Nakuru received KSh 1.93 billion, Nairobi KSh 1.57 billion, Homa Bay KSh 1.54 billion, Mombasa KSh 1.41 billion, and Kiambu KSh 1.27 billion.
Under the Facilities Improvement Financing Act No. 14 of 2023, payments are made directly to facility accounts to retain revenue for operations and improve service delivery.
The Authority explained that returned claims require facilities to correct coding or provide missing documents, while rejected claims do not meet legal or benefit-package requirements.
“We are seeing more clean claims after working closely with providers. Our priority remains paying every valid claim without delay,” SHA said.
