Duale Shuts Down Foreign Medical Referrals, Only Procedures That Are Not Available Will Receive Government Subsidy
The CS elaborated that the thrust is to save billions of shillings and avoid what he termed misappropriation of the referral system,
Health Cabinet Secretary Aden Duale has taken a fresh step towards shutting down foreign medical referrals, assuring that only patients in need of procedures not available in Kenya will receive government subsidy. Speaking during the press conference at the Uasin Gishu County on Wednesday, September 10, 2025.
By Mercy Chelangat
Health Cabinet Secretary Aden Duale has taken a fresh step towards shutting down foreign medical referrals, assuring that only patients in need of procedures not available in Kenya will receive government subsidy. Speaking during the press conference at the Uasin Gishu County on Wednesday, September 10, 2025, while launching the Social Health Authority (SHA) programme under the Taifa Care Initiative; Kenya’s national universal health coverage flagship programme, Duale confirmed that the Ministry of Health would gazette such treatments within one week.
The CS elaborated that the thrust is to save billions of shillings and avoid what he termed misappropriation of the referral system, whereby patients are on rare occasions referred abroad for procedures that can be done within the country. He added that only foreign hospitals that have signed and put in place SHA agreements would be allowed to take referred patients under the public health insurance scheme. Other Kenyans who wish to pay cash will continue to be free to go abroad for treatment.
“Those were days you could just hop to India because one doctor has referred you will not be there,” Duale continued, pointing out that some of the referrals are being driven by brokers and middlemen in pursuit of charges.
The government indicates that the new regulation would direct more funds to the country’s hospitals and save families the expense of mobilizing funds for expensive treatment in other countries. Duale further stated that since the SHA came into force in October 2024, it has paid out an estimated KSh 58 billion to the country’s hospitals. The Uasin Gishu County collected KSh 3.13 billion, with Moi Teaching and Referral Hospital collecting the most with KSh 1.3 billion.
The hospitals will be forced to document fully for payment and to confirm claims that are captured by the system. “They pay based on your claim. Approved claim. Rejected claim. There are some claims that are under surveillance by the system,” Duale continued.
One of the reform’s most important elements is the AI-driven digital health platform that searches referrals and payments in real-time. The system, in Duale’s words, is able to detect doubtful claims prior to money being withdrawn from the fund, safeguarding funds for patients.
The Ministry of Health is also expected to publish the gazette notice within one week. Duale clarified that the AI system will continue processing claims in real-time, rejecting dubious or incomplete claims lodged to safeguard money meant for patients.
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