NHIF verification team operations suspended over legal dispute
The committee had been established under Gazette Notice No. 4069 dated March 28, 2025.
A court has halted the operations of a committee set up to review pending claims at the National Health Insurance Fund, following a legal challenge questioning its legality.
Justice R. Nyakundi of the Eldoret High Court issued temporary orders stopping the NHIF Pending Medical Claims Verification Committee from undertaking any activity until a constitutional petition challenging its formation is fully heard.
The committee had been established under Gazette Notice No. 4069 dated March 28, 2025.
In his ruling, Justice Nyakundi said the committee is barred from compiling reports, making recommendations, or taking any action related to its mandate.
He also issued an order stopping the Health Cabinet Secretary, Aden Duale, the Principal Secretary, and the Attorney General from supporting or acting upon the notice.
"Pending the hearing and determination of this Petition, a conservatory order is hereby issued suspending the operation of the NHIF Pending Medical Claims Verification Committee and restraining the committee from compiling any report, recommendations, or undertaking any actions pursuant to the said Gazette Notice," Justice Nyakundi ruled.
The petition was filed by Nakuru-based surgeon Dr. Benjamin Magare Gikenyi and three others, who argue that the committee was created without proper legal backing.
They claim that its work interferes with the constitutional duties of the Auditor-General.
The committee was assigned the task of examining NHIF claims made between July 2022 and September 2024.
The petitioners argue that this is a role that falls under the jurisdiction of the Auditor-General, as provided for in Article 229(4)(g) of the Constitution.
According to the court, "The committee established by the Gazette Notice has been tasked with scrutinizing and auditing NHIF claims spanning a specific period. If the committee proceeds to complete its mandate before the constitutional questions raised in the petition are determined, there would be limited practical remedy available even if the petition were ultimately successful."
They further maintain that for an audit to be valid, it must follow a request by the Health Cabinet Secretary to the Auditor-General, as outlined under Article 254(2) of the Constitution and Section 37 of the Public Audit Act.
Justice Nyakundi ruled that the applicants had satisfied the requirements needed for the issuance of a conservatory order.
However, he clarified that the court had not taken a position on the main issues raised in the petition.
"I emphasize again that this determination in no way prejudges the merits of the main petition, which will be determined after full arguments from all parties," he said.
The case will be mentioned again on June 2, 2025.
