The Social Health Authority (SHA) has announced a nationwide contracting exercise targeting hospitals, clinics, and other healthcare providers seeking to offer services under Kenya’s new health insurance system.
In a public notice issued on Thursday, September 17, the authority invited eligible, qualified local healthcare providers and facilities to submit Expressions of Interest to contract under Specially Permitted Procurement Procedure No. SPPP/SHA/002/2026-2027.
The exercise covers providers seeking to serve beneficiaries of the Primary Healthcare Fund (PHCF), Social Health Insurance Fund (SHIF), Emergency, Chronic and Critical Illness Fund (ECCIF) and the Public Officers Medical Scheme Fund (POMSF).
SHA said the contracting process is being undertaken under Sections 33 and 34 of the Social Health Insurance Act, 2023, which require the authority to contract healthcare providers the deliver services under the funds it administers.
The authority said the contracting process will be open to all eligible and qualified local healthcare providers and facilities that meet the prescribed requirements.
Under the program, contracted facilities will provide healthcare services in accordance with approved benefit packages, service scope, and reimbursement tariffs under the Social Health Insurance Act and its regulations.
Providers must also follow claims submission procedures, reimbursement mechanisms, reporting obligations, quality standards, and other contractual requirements set by the authority.
SHA on Eligibility Requirements
SHA said applicants must be duly registered, licensed, and accredited by the relevant regulatory bodies to provide healthcare services in Kenya.
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Healthcare providers will be required to submit several compliance documents, including certificates of registration, valid operating licenses, county permits where applicable, KRA tax compliance certificates, SHA compliance certificates and other licenses relevant to the services they intend to offer.
The authority said it will only contract facilities for healthcare services they are licensed and accredited to provide.
SHA further stated that all applications will undergo verification, assessment and due diligence before approval.
As part of the process, the authority will conduct Know Your Customer (KYC) evaluations to verify the existence, ownership, licensing, accreditation status, capacity, and quality of the healthcare services applicants offer.
The evaluations will also assess whether facilities have the infrastructure, equipment, human resources, and operational capacity needed to provide the services for which they are seeking contracts.
Only facilities that satisfy the prescribed eligibility, verification, and assessment requirements will proceed to the contracting stage.
Continuous Onboarding
SHA said registration and onboarding of healthcare providers will remain a continuous process throughout the contracting cycle.
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The authority noted that eligible providers can continue applying for contracts until six months before the expiry of each three-year contracting period.
All new applicants will undergo the same eligibility checks, evaluations, verification procedures, and contracting requirements before being admitted into the system.
Successful healthcare providers will receive contracts valid for three years, subject to mid-cycle performance reviews and continued compliance with statutory, regulatory, and contractual obligations.
According to the notice, the contracts will outline service terms, approved benefit packages, reimbursement arrangements, tariffs, reporting requirements, quality standards and other operational obligations expected of providers.
Applications will primarily be submitted through SHA’s electronic contracting platform.
However, the authority said it may undertake manual contracting through county offices where the electronic system is unavailable or non-functional.
Healthcare providers that qualify for contracts will have seven days to review, sign, and return the contract documents before SHA executes them.
“Meeting the eligibility requirements, verification, assessment and due diligence criteria shall not automatically entitle an applicant to contract award, and SHA reserves the right to contract healthcare providers and facilities based on applicable laws, regulations and strategic purchasing considerations,” SHA stated.
SHA added that the list of successfully contracted healthcare providers and facilities will be published on its website in line with the requirements of the Social Health Insurance Act.
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