The Rural and Urban Private Hospitals Association of Kenya (RUPHA) has directed all private hospitals to demand cash payments from patients covered under the Social Health Authority (SHA).
In a statement, the RUPHA management said the new policy takes effect on Monday, September 22, 2025.
The association said the decision was prompted by delayed and unsettled payments from the SHA, which have made it unsustainable for private hospitals to continue offering services on credit.
“Please be advised that, effective today, all healthcare services (unless otherwise stated) at this facility for Social Health Authority (SHA) beneficiaries will be provided on a cash basis,” RUPHA stated.
RUPHA expressed regret over the inconvenience caused by the directive but emphasized that the move was necessary to keep private hospitals operational.
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“We regret the inconvenience this may cause and assure you that this action is driven by our commitment to ensure that: Hospitals remain open, essential supplies and equipment are available, and our staff can continue to serve you with the highest standards of care,” the association added.
This comes weeks after RUPHA issued a 14-day go-slow notice to the Ministry of Health over the NHIF and SHA debt.
In a statement on September 5, RUPHA demanded the settlement of the NHIF debt and payment of 50 percent of outstanding SHA liabilities within 14 days.
“RUPHA hereby issues a 14-day go-slow notice effective today for the Social Health Authority (SHA) to address the following: Immediate settlement of NHIF liabilities in line with the Presidential Directive of 5th March 2025 and payment of at least 50% of the Ksh43B outstanding SHA liabilities within 14 days,” said the association.
On September 8, RUPHA Chairperson Brian Lishenga warned that private hospitals risk closing down by December 2025 if the government fails to clear outstanding debts.
He also said private hospitals may be forced to switch to a 100 percent cash payment model before patients can receive treatment.
“We are Ksh76 billion in debt as a sector, Ksh33 NHIF debt, and Ksh43 billion SHA liability. The health sector cannot continue bearing this burden.
“What we are saying is that if the NHIF debt is not paid immediately, it is very likely that by December, either you will not have private hospitals or the entire system will revert to 100 percent cash,” he said.
