Private hospitals under the Rural Private Hospitals Association of Kenya (RUPHA) have officially resumed offering services under the Social Health Authority (SHA) insurance scheme. This follows a government commitment to settle outstanding arrears owed to healthcare facilities under the now-defunct National Hospital Insurance Fund (NHIF).
RUPHA Chairman Brian Lishenga announced on Thursday that the decision to call off the boycott was reached after extensive deliberations with stakeholders. He emphasized that while the directive does not completely resolve all concerns, it marks a significant step towards alleviating the financial challenges faced by private hospitals.
The government, through State House, pledged to clear all pending NHIF payments for hospitals owed Sh10 million or less. This move will cover 91% of the facilities that were previously contracted under NHIF. For hospitals with claims exceeding Sh10 million, a verification process will be conducted over the next 90 days, after which a structured payment plan will be agreed upon.
Despite resuming SHA services, RUPHA maintained that hospitals will continue to suspend services under Medical Administrator Kenya Limited (MAKL). The association cited the company’s failure to reconcile outstanding debts, issue remittance advice, or provide clarity on payments due to healthcare providers. Lishenga stressed that until MAKL and its underwriters—Minet and CIC—take corrective action, RUPHA will escalate the matter to regulatory and legal bodies.
The hospitals had initially suspended SHA services on February 24, citing delayed NHIF payments, an unsustainable outpatient reimbursement model, and a lack of government intervention. With the latest developments, RUPHA has vowed to closely monitor the government’s actions to ensure full implementation of its commitments.
Lishenga further warned that if the verification process for large hospital claims takes longer than the promised 90 days or if upfront payments are not made for facilities owed over Sh10 million, RUPHA will take further action, including pushing for parliamentary intervention and potentially reinstating the service suspension.
The government’s intervention provides temporary relief for healthcare providers, but ongoing oversight will be necessary to ensure that hospitals receive their rightful payments.
