Gov’t Responds After Private Hospitals Suspended SHA Services

The Ministry of Health (MoH) has dismissed claims by the Rural & Urban Private Hospitals Association of Kenya (RUPHA) that the government owes them Ksh30 billion. 

In a statement on Tuesday, February 25, the Ministry said a consultative meeting was held on Monday where key resolutions were made to enhance service provision in RUPHA facilities.

“A consultative meeting was held on February 24, 2025, between the Ministry of Health and RUPHA leadership, where key resolutions were made to enhance service provision in RUPHA facilities. We wish to clarify that the Government does not owe RUPHA Ksh30 billion, as asserted,” read the statement in part.

The ministry said it recognizes the contributions of RUPHA and the Kenya Association of Private Hospitals (KAPH) in providing healthcare services to SHA beneficiaries.

MoH noted that RUPHA facilities will receive training on claim management to improve the accuracy of claim submissions and prevent delays.

The ministry also called on RUPHA members to continue working with SHA to ensure the uninterrupted provision of healthcare services.

At the same time, MoH said it is committed to settling pending National Health Insurance Fund (NHIF) claims.

“The government remains committed to honoring undisputed NHIF claims. As of October 4, 2024, Kes 10 billion out of Kes 19 billion in undisputed NHIF claims has already been paid.

“SHA is working with healthcare providers to finalize NHIF pending claim reconciliations, which are currently 60% complete. Healthcare facilities must provide proof of archived claims to facilitate verification before payments are processed,” the Ministry added.

This comes a day after KAPH suspended all credit arrangements under the SHA insurance scheme and Medical Administrator Kenya Limited (MAKL) indefinitely.

KAPH expressed concern over financial instability caused by unresolved inefficiencies in the NHIF-SHA transition and an unclear operational and reimbursement framework for outpatient services among other issues.

On February 20, 2025, RUPHA announced plans to suspend SHA services in their facilities over pending NHIF debt.

RUPHA lamented that the government had yet to pay over Ksh30 billion in NHIF debt despite past promises.

The association added that it was forced to take the decision following failed engagements with the government on the pending bills.

"As healthcare professionals, our first duty is the welfare of our patients. However, the continued failure to address critical challenges in the SHA transition is now directly endangering the quality and sustainability of care in our hospitals,” RUPHA stated.