Amid rising cases of health facilities making fraudulent payment claims, the government has come up with a biometric screening system meant to eliminate loss of money.
This comes in the wake of reports that some hospitals and medical staffers are involved in illegal money minting schemes by making double claims for refunds to the Social Health Authority (SHA).
Health Cabinet Secretary Aden Duale, who was speaking during the launch of a Biometric Health Identification (BHI) system at Kenyatta University Teaching Referral and Research Hospital (KUTRRH), said patients will no longer be required to present documents for verification on their SHA compliance.
The launch of the system means Kenyans will no longer use One Time Password (OTP) authorisation during registration under SHA but would instead use two innovations, Biometric Health ID (BHI) and Practise360 App, to onboard, an exercise that is already live at all Level 4-6 hospitals across the country.
BHI enables secure, document-free access to care using fingerprints, cutting fraud, paperwork and wait times while Practise360 App is a geo-fenced tool enabled to curb misuse of medical pre-authorisations.
“With immediate effect, SHA will not accept OTP based authorisation. All approvals must be completed using the Biometric Health ID or Practise360 App,” Health Cabinet Secretary Aden Duale said during the launch of the new system and innovations at the Kenyatta University Teaching, Research and Referral Hospital (KUTRRH).
“As of now, the biometric registration is now live in all level 4,5 ad 6 facilities, with ongoing efforts to onboard level 3 and 2 facilities across the country. We have also launched the practice 360 app today, which we have launched today and is now live from this minute and is geo-tapped to specific health facilities where healthcare professionals are stationed,” he added.
For years, Kenya’s public healthcare system has been silently bleeding billions through fraudulent claims lodged by unscrupulous health facilities and medical staff.
Hospitals, clinics, and even some practitioners have been accused of minting illegal cash by making double claims for refunds to the Social Health Authority (SHA), a practice that has eroded public trust and strained resources meant for patient care.
Some health facilities would bill SHA multiple times for the same patient visit, file for services never rendered, or charge for drugs that were never dispensed.
According to the government, the racket has resulted in massive losses of money that could otherwise strengthen the country’s universal health coverage ambitions.
Duale said the biometric system will help eliminate fraud and misuse of benefits, enhance accountability and also reduce paperwork, cut down on long queues, and allow our health workers to spend more time on actual patient care.
“This innovation will secure access to health services without having physical documents. It will help us eliminate fraud and misuse of benefits, reduce paperwork, shorten queues, and allow health workers to spend more time on patient care,” he said.
To fully heal the system that had started to rot, the government has gone beyond billing, extending its crackdown to pharmaceutical companies.
Duale unveiled National Product Catalogue, which has the ability to block fake drugs by ensuring only verified medicines are used and the Health Information Exchange (HIE), which enables secure sharing of patient data across facilities and counties.
He ordered all pharmaceutical firms to upload certified product data within 30 days or face deregistration saying the move is part of an effort to rid the market of counterfeit and substandard drugs.
“Failure to comply will result in deregistration and delisting from the SHA ecosystem. This catalogue ensures only authorised, safe, and approved pharmaceutical products are administered to Kenyans, eliminating counterfeit drugs. Effective immediately, SHA will only reimburse for drugs actually dispensed to patients by health facilities,” warned the CS.
Duale also warned that any facility caught double-billing will be suspended immediately assuring that every patient interaction from diagnosis to prescription will now be recorded and tracked in real time.
“These reforms will stop theft, manipulation, and ghost billing in the public system. Non-compliant and fraudulent facilities will be deregistered by the Kenya Medical Practitioners and Dentists Council within the Taifa Care Network,” he affirmed.
The CS added that the move marks a major milestone in transforming Kenya’s healthcare through the digital superhighway and the Bottom-Up Economic Transformation Agenda (BETA).
“This digital superhighway will work as the backbone that forms the backbone of a transparent, patient-centred and efficient health system,” Duale said.
He noted that 99 per cent of walk-in patients at KUTRRH are enrolled in SHA, with 29 biometric devices active.
Duale said the ministry will next month launch a pharmaceutical Track-and-Trace system and enhance digital oversight through Kenya Medical Practitioners and Dentists Council (KMPDC) to weed out fraudulent facilities under Taifa Care, adding that the digital tools mark a new era of efficient, transparent and patient-focused healthcare delivery.
So far, over 25 million Kenyans have been registered under the SHA scheme, with more than 10,000 hospitals, clinics, and health centres contracted.
Since inception, SHA has reimbursed hospitals to the tune of Sh47.5 billion, while level two and three facilities have received Sh6.9 billion under the free Primary Healthcare Fund.
