Govt Says Private Hospitals Paid Up To January As SHA Suspension Persists

The government has announced that it has cleared private hospital claims up to the end of January, even as the suspension of the Social Health Authority (SHA) services by private hospitals enters its fourth day.

The Rural and Urban Private Hospitals Association of Kenya (RUPHA) claims that the government still owes them Sh30 billion in unpaid arrears.

However, Health Cabinet Secretary Deborah Mulongo has dismissed the claim, stating that SHA has been settling verified payments on a monthly basis.

“It is important to clarify that SHA payments have been made to private, faith-based, and government hospitals, including Sh5.1 billion that was paid on Monday. RUPHA-affiliated hospitals have received all payments for claims up to the end of January 2025,” Mulongo said.

According to the CS, SHA inherited a significant amount of debt from the now-defunct National Health Insurance Fund (NHIF), creating a financial strain on the healthcare system. Since September, the Ministry of Health has disbursed Sh8.6 billion to settle NHIF debts.

To ensure fairness and transparency, SHA has been verifying NHIF claims and reconciling payments with healthcare providers before making settlements. The verification process involves confirming the legitimacy of claims and signing agreements with hospitals before a structured payment plan is developed.

Mulongo assured that the Ministry of Health remains committed to engaging with hospitals and other stakeholders to address any challenges.

As of January 31, 2025, SHA had collected Sh20.9 billion and processed claims for both public and private hospitals. Of these funds, Sh18.2 billion has been paid out—Sh16.97 billion for Social Health Insurance Fund (SHIF) claims and Sh1.33 billion for Primary Health Care capitation under the Taifa Care program.

Despite this, RUPHA suspended SHA services on Monday, citing financial instability caused by unpaid claims from last year. The Kenya Association of Private Hospitals (KAPH) also halted SHA and Medical Administrator Kenya Limited (MALK) services after a resolution was passed in a Special General Meeting on February 24, 2025.

KAPH Chairman Erick Musyima said the suspension was necessary due to ongoing financial difficulties, including salary delays, staff layoffs, and shortages of medical supplies. He blamed the transition from NHIF to SHA, saying it has been mismanaged and lacks clear reimbursement structures for outpatient services.

Musyima also accused the government of failing to honor payments, saying that despite multiple negotiations, private hospitals have yet to receive the Sh30 billion they are owed.

“KAPH is ready to engage in meaningful discussions with the relevant authorities to address these systemic failures and prevent further deterioration of healthcare services in Kenya,” Musyima stated.

However, the government has refuted claims of a Sh30 billion debt, saying it is processing payments for private hospitals as scheduled. It has also announced plans to train RUPHA-affiliated hospitals on claims management to improve accuracy and reduce delays.

SHA says it has already cleared 60 percent of NHIF’s pending bills, amounting to Sh10 billion out of Sh19 billion. Additionally, it has disbursed Sh1.3 billion to primary healthcare facilities, including government hospitals and select Level 4 private hospitals, with 51 percent of the funds allocated to private providers.

“We wish to assure the public that primary healthcare services remain available at all government facilities free of charge, with no limits, as long as one is registered with SHA,” SHA said in a statement.