RUPHA raises alarm over unpaid healthcare bills risking sector collapse

The Rural and Urban Private Hospitals Association of Kenya (RUPHA) has raised alarm over astronomical figure of the outstanding debt owed by the Social Health Authority (SHA) and the National Health Insurance Fund (NHIF) to the private sector amounting to Ksh43 billion.

The association now warns that the country’s healthcare system risk grinding to a halt if the government doesn’t pay the outstanding debt immediately.

Speaking during a presser in Meru town led by RUPHA Chairperson Dr. Brian Lishenga and Vice Chair Rev. Joseph Kariuki, the practitioners said since SHA’s launch in October 2024, hospitals have submitted claims worth Ksh93 billion, yet only 53% (about Ksh50 billion) has been reimbursed.

The association represents more than 700 private and faith based sponsored hospitals. Dr. Lishenga said Ksh43 billion shortfall, coupled with Ksh33 billion in unpaid NHIF arrears, has left facilities crippled by debts exceeding Ksh76 billion.

He termed the debt as a systemic financial neglect by the government, adding that the viability of hospitals is at risk due to delayed or missing payments from SHA and the now-defunct NHIF.

ALSO READ:

Duty-free rice imports capped at 250,000 tonnes after landmark court ruling

“Since the inception of SHA in October 2024, Kenyan hospitals have submitted claims worth Ksh93 billion, yet only Ksh50 billion has been reimbursed. We are now owed Ksh43 billion in unpaid SHA liabilities,” said Dr. Lishenga.

The practitioners are now calling on President William Ruto’s administration to fast tract payment of NHIF and SHA pending bills that amount to Ksh76billion (Ksh33billion NHIF plus Ksh43billion SHA) owed to Kenyan hospitals.

They said the SHA public Portal is publishing misleading information and propaganda.

“Despite a ministerial directive that SHA reimbursements to facilities be made on the 14th of every month, this has not been honoured. Lishenga said that persistent non-payment of Primary Health care reimbursement continues in Mombasa, Kirinyaga, Embu and Nandi counties which are key in piloting the Digital Super highway.

“Hospitals in these counties are under resourced, under motivated and unable to deliver the government’s free primary healthcare. RUPHA is gravely concerned about the deletion of bed capacity and downgrading of facilities in the SHA portal, despite these facilities holding valid KMPDC licences,” he said.

Kariuki said the ministry of health has weaponized fraud controls instead of addressing the flawed proxy means testing model and unaffordable annual premiums that burden Kenyans.

ALSO READ:

SHA disburses Ksh3.4 billion to health facilities

“Hospitals are facing insolvency while the government delays action. Private hospitals responsible for 50 percent of health services in Kenya continue to face discrimination treatment. RUPHA remains committed to working with the health ministry but will not remain silent as hospitals collapse under debt, patients denied care and UHC being reduced to a political slogan,” Kariuki noted.

He said hospitals are facing great challenges of paying their workers and suppliers while some institutions even sacking employees due to lack of funds.

The group also decried what it termed as unlawful downgrading and removal of licensed healthcare facilities from the SHA system, citing violations of Gazette Notice No. 269 of 2021 and other legal safeguards.

Dr. Lishenga called on the government to urgently settle outstanding bills, restore transparency in reimbursements, stop arbitrary downgrades of facilities, and ensure fair treatment of private hospitals that provide nearly half of Kenya’s healthcare services.

“The health sector is on the brink. Many hospitals are now demanding cash only payments, while others risk closure especially in rural counties like Wajir, Mandera, Marsabit, and Samburu, where private facilities are often the only lifeline,” said Dr. Lishenga.

By John Majau.

Sharing is caring!