The Rural and Urban Private Hospitals Association of Kenya (RUPHA) has raised concerns over delays in the settlement of National Health Insurance Fund (NHIF) arrears, despite a presidential directive issued more than five months ago.
In a statement on Friday, August 15, the association expressed frustration over the lack of action since the directive was made on March 5, 2025.
RUPHA noted that healthcare facilities across the board, whether public, private, or faith-based, are yet to receive payments owed to them.
"On behalf of the Rural and Urban Private Hospitals Association of Kenya (RUPHA), we write to express our deep concern regarding the continued delay in the fulfillment of the Presidential directive issued on 5th March 2025 regarding the settlement of NHIF pending bills.
"As of today, 14th August 2025, it has been 162 days-more than five months-since this directive was issued, yet no healthcare facility-public, private, or faith-based-has received any payment for the NHIF arrears it is owed," the statement read.
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In response, RUPHA has outlined measures it wants implemented before the payment deadline, including a formal assurance that smaller claims will be settled in the coming weeks.
"We ask that you issue a formal written commitment to all providers confirming that verified NHIF claims of Kshs 10 million and below will be settled on or before 9th September 2025, as earlier promised," the statement added.
RUPHA also wants transparency on the amounts each facility is set to receive, so that any discrepancies can be addressed before disbursement.
"We request that you instruct the Social Health Authority to, within the next two weeks, publish the pending claim amounts per facility that are earmarked for payment. This transparency will allow providers who may disagree with the listed amounts to file appeals or submit clarifying evidence with their local SHA branches," the statement continued.
For larger claims that had already undergone verification in the past financial years, the association is calling for immediate settlement.
"For facilities that had completed the NHIF-led claim verification and sign-off process in 2023/2024, we request that the SHA be instructed to settle these uncontested liabilities immediately, as no further verification is required," the statement further read
In addition, the association proposes the reactivation of branch-level verification for facilities whose claims had not been processed earlier.
"For facilities that did not undergo the prior NHIF sign-off process, we propose that the SHA be directed to reactivate its internal branch-led claims verification process and complete it within the next three months, in line with the High Court's guidance," the statement concluded.
On Wednesday, March 5, President William Ruto announced a plan to clear the outstanding debt left by NHIF, acknowledging the financial strain caused by the debts on health facilities.
"National Health Insurance Fund (NHIF) debts have been a heavy burden on healthcare facilities and providers for the past 10 years. This has had a devastating effect in the provision of health services in public, faith-based and private hospitals.
"By the time the NHIF was wound up in November 22 2024, it had a whopping debt of Ksh33 billion, affecting the ability of health facilities to provide services under the Social Health Authority (SHA)," the statement read.
To address the debt crisis, Ruto said the government would make full payments to hospitals with claims of Ksh10 million and below.
He added that hospitals with claims exceeding Ksh10 million will undergo a verification process to be completed within 90 days before a structured payment plan is implemented.
"The government has resolved to pay all hospitals with total claims of Ksh10 million and below in full, representing 91 per cent of all facilities that were contracted by NHIF.
"The remaining 9 per cent of hospitals, with total claims of above Ksh10 million, will be subjected to a verification exercise that should be completed within 90 days after which a payment plan will be agreed on," the statement added.
