Nearly two months after President William Ruto promised to settle billions owed to private hospitals by the now-defunct National Hospital Insurance Fund (NHIF), healthcare providers remain in a state of uncertainty and frustration. Despite assurances made in March that all claims below Sh10 million would be cleared immediately while larger claims would undergo verification within a 90-day window, the situation has barely progressed. Members of the Kenya Association of Private Hospitals (KAPH) and the Rural & Urban Private Hospitals Association (RUPHA) have voiced growing concerns, highlighting that no substantial communication has been made by the relevant government bodies, leaving hospitals grappling with financial strain.
In his March address, President Ruto had emphasized the urgent need to address the mounting debt, stating that settling the smaller claims would provide much-needed relief to 91 percent of the healthcare facilities previously contracted by NHIF. Larger claims, he explained, would be subject to a thorough verification process before payment terms could be agreed upon. To oversee this process, a verification committee was established and officially gazetted on March 28, with its inauguration taking place on April 8 under the leadership of Cabinet Secretary Aden Duale. Despite the formation of the committee, however, hospitals report that no tangible steps have been taken towards fulfilling the President’s pledge.
According to Dr. Eric Musau, Chairperson of KAPH, hospitals have not received clear guidelines on how or when their claims will be processed. Speaking to the Nation, Dr. Musau lamented the absence of direction from the Ministry of Health, suggesting that ongoing administrative changes within the ministry and the newly formed Social Health Authority (SHA) could be contributing to the delay. He noted that hospitals are left operating on the basis of the President’s goodwill, with no concrete framework to determine whether claims under Sh10 million should be considered processed or still awaiting approval. Under the old NHIF system, an invoice raised by a facility would first be verified by a processing office before being sent to a payments department. This procedural ambiguity has left many providers unsure where their claims currently stand.
By the time NHIF was dissolved in late November 2024, outstanding hospital claims had reached a staggering Sh33 billion, accumulated over a two-year period from July 2022 to September 2024. President Ruto himself had acknowledged the severity of the problem, admitting that the vast debts had severely impacted hospitals’ ability to deliver services under the newly established SHA framework. The financial burden has not only strained operational capacities but also raised fears about service interruptions, particularly among faith-based hospitals that initially threatened to withdraw services if debts were not settled within a two-week window. Although these hospitals later suspended their ultimatum following talks with the President, the lack of follow-through has reignited anxiety across the sector.
Dr. Brian Lishenga, Chairperson of RUPHA, echoed the frustration, explaining that his members are equally in the dark about the status of their pending claims. With facilities already facing financial pressure from rising operational costs and delayed reimbursements, the prolonged uncertainty threatens to erode trust between private healthcare providers and the government. As the verification committee remains inactive and communication channels remain silent, hospitals are left waiting for action to match the promises made. Without swift intervention, the stalemate risks undermining healthcare delivery at a critical time when stability and support are most needed.
