Private and faith-based hospitals have warned they may soon shut their doors over unpaid government reimbursements totaling Ksh76 billion.
The Rural & Urban Private Hospitals Association of Kenya (RUPHA), which represents over 700 hospitals nationwide, has accused the Social Health Authority (SHA) and the Ministry of Health of starving hospitals of critical funds.
RUPHA revealed that since SHA was launched in October 2024, hospitals have submitted claims worth Ksh93 billion.
Only Ksh50 billion (53%) has been reimbursed, leaving hospitals with Ksh43 billion in unpaid liabilities.
“Hospitals across Kenya are on the brink. Many have already shifted to cash-only payments, while others are preparing to shut their doors,” said Dr. Brian Lishenga, RUPHA Chairman.
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Private Hospitals Accuse Govt
According to Dr. Lishenga, despite a directive from the Ministry of Health that SHA reimbursements be made on the 14th of every month.
However, the commitment has never been honored.
“The SHA claims to be transparent by publishing facility-level reimbursements online. But without showing how much was claimed versus what was actually paid, this is propaganda, not transparency,” he noted.
Moreover, the association has indicated that it results to an insult to Universal Health Coverage (UHC).
Hospitals in Mombasa, Kirinyaga, Embu, and Nandi counties, which are piloting the Digital Superhighway, have not received payments for Primary Healthcare services.
Instead of streamlining claims, the Digital Superhighway has created new bottlenecks that leave facilities under-resourced and demoralized, according to RUPHA.
“How can the government promise Kenyans free primary care when hospitals on the ground are not being paid?” RUPHA questioned.
Illegal Downgrades and Bed Deletions
RUPHA also accused SHA of arbitrarily deleting bed capacity and downgrading private facilities despite them holding valid medical licenses.
According to the association, over 10,000 inpatient beds and nearly 3,500 maternity beds have been erased from Level 2 and Level 3C facilities on SHA’s portal.
“These downgrades are unlawful and unconstitutional. There is no due process, no lawful framework, and no appeals mechanism. Private hospitals are being unfairly targeted,” the association said.
The crisis has been compounded by NHIF pending bills, which remain unpaid 168 days after a presidential directive ordered their clearance.
Hospitals were promised that all debts under Ksh10 million would be paid within 90 days, but not a single shilling has been released.
RUPHA estimates that NHIF owes hospitals Ksh33 billion, on top of the Ksh43 billion owed by SHA, creating a combined debt burden of Ksh76 billion.
“The President spoke. Hospitals are still waiting. Instead of being paid, they are sinking into insolvency,” added the statement.
Also Read: Private Hospitals Fire Back After Govt Threat to Shut them Down Over Ruto Billions
Private Sector Discrimination
The private hospitals have noted that although they account for 50% of Kenya’s healthcare services, they are being unfairly singled out.
Legitimate claims for surgeries and inpatient admissions have allegedly been placed under review for over four months without explanation.
RUPHA has advised that although fraud control is important, the Ministry of Health is weaponizing it to avoid paying hospitals, instead of fixing deeper problems like unaffordable premiums and the flawed Proxy Means Testing model.
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