Rural and Urban Private Hospitals Association of Kenya (RUPHA) suspends services under Social Health Authority (SHA) Insurance Scheme

NAIROBI, Kenya, Feb 20…The Rural and private Hospitals Association of Kenya (RUPHA) has announced suspension of services under the Social Health Authority (SHA) insurance scheme beginning Monday 24th February 2025.

They highlighted continued failure in addressing critical issues surrounding SHA transition now endangering quality and sustainability of care in hospitals noting that the decision has been made following months of failed engagements, unfulfilled promises and growing financial distress among hospitals.

“Despite numerous with government authorities settlement of Historical NHIF arreas amounting to Ksh 30 billion and rejection of unworkable SHA outpatient reimbursement model”, said Dr. Brian Lishenga, Chairman RUPHA.

Subsequently, they add that Social Health Authority has flatly refused the debts arguing that NHIF liabilities are not its responsibility which has pushed hospitals into financial crisis leaving them unable to deliver essential healthcare services.

SHA transition status report February 2025 highlighted disfunction in the the system which include SHA portal failures, delayed payments, patient verification failures, outpatient service collapse and SHA contact centre dysfunction.

“Financial neglect has led to stockout of essential medicines with Pharmaceutical supplies blacklist hospitals that cannot clear outstanding bills, many hospitals have lost doctors, nurses and support staff due to inability to pay salaries”.

In addition, they note that RUPHA members will no longer provide care under Medical Administration Kenya Limited (MAKL) scheme which covers police officers and teachers.

“MAKL has failed to pay hospitals for over 11 months forced hospitals to accept arbitrary and unexplained discounts and favoured its own clinics in an uncompetitive and unethical manner”, added Dr. Lishenga.

RUPHA calls upon government to act with immediacy on settling Ksh 30 billion NHIF arrears, revising the SHA outpatient reimbursement model and ensuring fair and timely payments under Medical Administration Kenya limited (MAKL) scheme.