Only nine counties meet SHA statutory remittance deadline

Only nine counties are complying on SHIF law.[File, Standard]

Only nine counties are complying with the law requiring them to remit Social Health Insurance Fund (SHIF) contributions by the ninth day of every month.

Data by Social Health Authority (SHA) shows 38 non-compliant counties have accumulated Sh418 million in unpaid contributions, with an additional Sh13.6 million for penalties.

Health Cabinet Secretary (CS) Aden Duale said the ninth-day deadline is a statutory requirement and not a matter counties can choose to ignore.

“The obligation to remit SHA contributions by the ninth of every month is settled in law. It is not something that people have a choice on,” said Duale.

Duale made the revelations on Monday, during a special Intergovernmental Budget and Economic Council (IBEC) meeting chaired by the Deputy President Kithure Kindiki.

The requirement is anchored in Section 27 of the Social Health Insurance Act, 2023, and Regulations 17 and 22 of the Social Health Insurance General Regulations, 2024.

It applies to households, employers, national and county governments and private-sector employers required to make the contributions.

Duale said late remittance attracts a monthly penalty, while unlawful failure to remit contributions constitutes a criminal offence under Section 48 of the Act.

The statutory payment cycle is also aligned with other deductions, including PAYE, the Affordable Housing Levy and NSSF contributions.

SHA said the July 2026 payment rate stood at 63.8 per cent, with the authority engaging individual counties to clear their outstanding obligations.

“We are talking to our counties, chiefs of staff and governors and we want to resolve it,” Duale said.

The revelations come amid a proposal to shift the statutory remittance deadline from the ninth to the 25th of every month.

Council of Governors (CoG) chairperson Ahmed Abdullahi had raised concerns over delays in remitance of SHA premiums, saying the problem had persistent for months.

According to CoG, delays in disbursement and payment for counties contribute to delay in remittance of SHA statuaries. With restricted statutory deductions, he said the majority of county staff are locked out of the SHA system.

“Governors had proposed to have counties allowed up to 21 days to remit premiums,” said the CoG chairperson.

However, according to the CS, any change would require amendments to the SHA General Regulations, 2024, and potentially the Social Health Insurance Act, with public participation likely to be required.

Also, the changes would attract legal challenges because the current deadline is entrenched in law.

“The proposal remains just a proposal. No change has been formalised or gazetted,” said Duale.

Nevertheless, Duale said the Ministry of Health was concerned about the impact of delayed remittances on SHA’s ability to settle claims.

“Even as of today, 33 counties have not remitted SHA statutory deductions.  Looking at what we have received against the claims lodged this month, we have a very big shortfall,” he said.

Under the current system, counties that fail to remit by the ninth face restrictions, with the SHIF system automatically locking out beneficiaries until payment is made.

Duale said any change to the deadline must therefore be carefully considered because it could disrupt the alignment of statutory deductions and complicate government returns.

During the recent Health Summit, President William Ruto directed the Ministry of Health and the Council of Governors to explore whether an agreement to make changes on SHA statutory remittance could be arrived at.

But during the engagement, Abdullahi, who represented County governments, maintained during the Health Summit that there was no challenge with SHA operations.

Abdullahi maintained that SHA was functioning smoothly, and that any Governor with a complaint should raise the matter independently with SHA leadership.

Meanwhile, SHA has continued paying healthcare providers despite the challenges in county remittances.

Duale said overall claim settlement currently stands at 78 percent.

Of Sh229.8 billion in claims owed to counties, SHA has paid Sh159.3 billion, while Sh41 billion remains under active review.

The authority expects to make further payments from the SHIF, Emergency, Chronic and Critical Illness Fund (ECCIF) and Primary Healthcare Fund.

SHA pays between Sh12 billion and Sh14 billion to healthcare providers every month, compared with about Sh5.2 billion previously paid under NHIF quarterly.

Cumulatively, SHA says it has paid Sh215 billion since its establishment.

However, Sh16.5 billion in claims submitted by counties have been rejected, with counties informed of the decisions.

Duale said 18 counties are settling claims at a rate of at least 80 per cent, while five are below 75 per cent, prompting plans for targeted engagements with governors and health facilities.

On the legacy NHIF debts, SHA said it has completed a facility sign-off exercise covering claims of Sh10 million and below per facility.

The exercise covered 3,526 healthcare facilities, which reconciled claims worth Sh3.98 billion, of which Sh3 billion has been paid.

A further Sh370 million owed to 461 facilities is undergoing verification before payment.

Duale said the government was keen to ensure that counties comply with the law while finding a workable solution to their concerns over the payment deadline.