Private hospitals across Kenya have resumed offering services under the Social Health Authority (SHA) insurance scheme after the government pledged to clear outstanding arrears owed to healthcare providers.
The Rural and Urban Private Hospitals Association of Kenya (RUPHA) announced the decision on Thursday, following extensive discussions on the government’s commitment to settling debts left by the now-defunct National Health Insurance Fund (NHIF).
“After extensive deliberations, we have reached a decision to call off the boycott of SHA services, effective immediately,“ RUPHA chairman Brian Lishenga stated.
The move comes after State House confirmed that hospitals with NHIF claims of Ksh10 million or less would receive full payment, a decision that affects 91 percent of all previously contracted facilities.
For hospitals with claims exceeding Ksh10 million, the government has proposed a verification process that will be completed within 90 days, after which a structured payment plan will be implemented.
Concerns Remain Over Unsettled Bills
While welcoming the government’s directive as a step in the right direction, RUPHA stressed that it does not fully resolve the financial strain hospitals have been facing. The association made it clear that it will be closely monitoring the government’s actions to ensure full compliance with its promises.
At the same time, RUPHA announced that the suspension of services under Medical Administrator Kenya Limited (MAKL) will remain in effect.
Lishenga attributed this to MAKL’s failure to address critical concerns raised by healthcare providers, including the lack of reconciliation of outstanding debts. He noted that without proper records, hospitals cannot track payments or verify pending balances.
Additionally, he criticized MAKL for failing to issue remittance advice for payments made, making financial accountability even more challenging.
RUPHA Threatens Further Action if Payments Stall
RUPHA has warned that if the government fails to fulfill its promises, the association will immediately reassess its position and convene its members to deliberate on the next steps, including the possible reinstatement of SHA service suspensions.
“If facilities owed over Sh10 million do not receive at least Sh10 million in upfront payments, we will escalate our engagement with Parliament to ensure that budgetary allocations are structured fairly,” Lishenga stated.
He also cautioned that if the claim verification process exceeds the promised 90-day period, RUPHA will demand an urgent review and may consider industrial action to push for a speedy resolution.
Lishenga further warned that unless MAKL and its underwriters, Minet and CIC, take immediate steps to resolve the outstanding financial issues, RUPHA will escalate the matter to regulatory authorities and pursue legal action.
“If MAKL and its underwriters do not take immediate action to resolve the issues raised, RUPHA will escalate the matter to regulatory authorities and pursue legal action to protect healthcare providers from exploitative financial practices,” he added.