The Rural Private Hospitals Association of Kenya (Rupha) has issued a 14-day ultimatum to the government to clear outstanding debts owed by the National Health Insurance Fund (NHIF), warning that failure to do so will result in withdrawal of services to NHIF and Social Health Authority (SHA) patients.
In a statement released this week, Rupha accused the government of ignoring a Presidential Directive issued on March 5, 2025, which ordered the settlement of hospital debts up to sh10 million.
The association says the continued delay is pushing healthcare providers into a financial crisis.
“NHIF liabilities currently stand at Ksh33 billion, while the SHA owes an additional Ksh43 billion. Combined, hospitals are owed a staggering Ksh76 billion — a debt burden that is simply unsustainable,” the statement read.
Rupha noted that even major public and mission hospitals are being affected, with some of the highest debts owed to:
- Kenyatta National Hospital: sh1.58 billion
- Moi Teaching and Referral Hospital: sh1.23 billion
- Kenyatta University Teaching, Referral & Research Hospital: sh540 million
- Nakuru County Hospital: sh297 million
The association cautioned against politicizing the issue, emphasizing that both public and private healthcare providers are suffering.
In addition, Rupha criticized SHA for what it described as the blanket rejection of legitimate claims.
It said hospitals are being denied rightful payments without due process, in violation of provider contracts that require feedback within 72 hours and formal rejection notices within 14 days.
“If the outstanding debts are not cleared within the next two weeks, hospitals will be forced to limit services for patients covered under NHIF and SHA,” the association warned.
Meanwhile, on August 25, Defence Cabinet Secretary Aden Duale revealed widespread fraud within the SHA.
Investigations uncovered several fraudulent practices, including: Upcoding, Falsification of medical records, Converting outpatient visits into inpatient admissions, Billing for non-existent patients (phantom billing).
Duale announced that claims worth sh10.6 billion had been rejected due to fraud or non-compliance.
He also said that since taking office on April 1, 2025, his ministry had implemented a new digital system powered by artificial intelligence to detect irregularities in claims processing and combat fraud across the healthcare system.
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