Kenyan citizens enrolled with the Social Health Authority (SHA) will not be able to use their coverage to pay for services at private hospitals.
Rural & Urban Private Hospitals Association of Kenya (RUPHA), which represents private hospitals nationwide, has today suspended services for SHA patients.
In a circular seen by Techweez, RUPHA stated, “ The decision has been taken due to delayed and unsettled payments by SHA, which has made it unsustainable for hospitals to continue offering services on credit.”
For now, SHA beneficiaries seeking private hospital health services will have to do so on a cash basis.
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The directive is a big blow, given that the body represents 700 health facilities across Kenya. However, RUPHA says the move was necessary as it intends to ensure the hospitals maintain the highest standards of care.
This action follows the expiry of RUPHA’s two-week notice on September 19. The notice, issued on September 5, outlined specific concerns that were not resolved, making it impossible for providers to continue extending credit to the SHA.
Financially, RUPHA claims that as of August 2025, SHA owes hospitals KES 43 billion, with another KES 24 billion in claims under review.
Monthly reimbursements of KES 5.4 to 6 billion lag behind claims worth KES 8.8 billion, leaving hospitals effectively subsidizing the system, risking closure, especially in vulnerable counties.
In the short term, RUPHA is demanding immediate settlement of all NHIF arrears below KES 10 million as per presidential instruction. It would also like verification and payment processes for larger claims to be expedited.
Other demands include the reversal of all unjust claim rejections, the establishment of an independent tribunal to resolve disputes, and urgent reforms to the SHA’s financing model.
