Kenya’s Social Health Authority (SHA) has temporarily suspended M.P. Shah Hospital from its panel of contracted healthcare providers, effective immediately. The private medical facility has been suspended due to alleged billing irregularities.
The suspension covers services across all four SHA funds: the Primary Healthcare Fund (PHCF), the Social Health Insurance Fund (SHIF), the Emergency, Chronic, and Critical Illness Fund (ECCIF), and the Public Officers Medical Scheme Fund (POMSF).
In a statement seen by Techweez, the hospital confirmed receiving the suspension notice.
“M.P. Shah Hospital has received a notice from the Social Health Authority (SHA) temporarily suspending our contract for the provision of services to SHA/SHIF beneficiaries, pending an investigation into billing complaints.”
Acknowledging the nature of the allegations, the private hospital has promised to cooperate with authorities and also carry out internal investigations.
“If any of our patients were required to make payments that should have been covered under their SHIF benefit, that falls short of the standard we hold ourselves to, and we are committed to investigating and correcting it,” the hospital added.
Current patients admitted at the facility under the cover of SHA are expected to continue receiving treatment with the public health insurance set to foot the bill.
“Beneficiaries already admitted at the facility before the suspension date shall continue receiving care till completion of their current episode of care and discharge,” the authority stated in a notice signed by SHA Chief Executive Officer Dr Mercy Mwangangi.
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However, beneficiaries not admitted to M.P. Shah but requiring follow-up medical services from the hospital during the suspension period are advised to seek care from other SHA-contracted facilities.
SHA has suspended healthcare facilities in the past; last year, it suspended 40 in August.
Notably, with a current capacity of 210 beds, 30 dedicated critical care beds, 10 renal dialysis units, and 12 chemotherapy units, M.P. Shah is the biggest private hospital to be suspended since the insurance model was rolled out.
