The Social Health Authority (SHA) has denied claims that it owes rural private hospitals a total of Sh30 billion.
In a statement to newsrooms, SHA asserted that claims by the Rural-Urban and Private Hospitals Association (RUPHA) were untrue.
“We encourage RUPHA members to continue working with SHA to ensure the uninterrupted provision of healthcare services,” the authority urged.
Patients seeking health services at facilities under RUPHA were turned away in various parts of the country due to the suspension of services by over 600 facilities, citing unpaid claims.
On February 20, 2025, RUPHA announced plans to suspend, citing unpaid NHIF arrears, an unworkable outpatient reimbursement model, and government inaction in addressing persistent challenges.
“The relevant authorities have ignored the challenges facing this new healthcare system, putting patients’ lives at risk and threatening the survival of hospitals due to weak service provision,” RUPHA chairperson Brian Lishenga said.
RUPHA said it is demanding that the government settle the Sh30 billion NHIF arrears in full. The association is also calling for a revision and streamlining of the SHA outpatient reimbursement model to ensure that facilities are adequately compensated.
Additionally, RUPHA wants the government to guarantee fair and timely payments under Medical Administrators Kenya Limited, which manages medical schemes for police officers and teachers.
Lishenga noted that 54 per cent of hospitals have not received payments from SHA, while 89 per cent of facilities have reported failures in the SHA portal.
He further stated that 83 per cent of hospitals struggle to verify patient eligibility due to frequent system glitches.
In the statement released on Tuesday, SHA said RUPHA facilities will receive training on claim management to improve the accuracy of claim submissions and prevent delays.
“RUPHA facilities have been trained on accessing claims through an online dashboard, enabling them to track their payments efficiently,” SHA added.
SHA noted that 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.
