NAIROBI, Kenya – The Rural & Urban Private Hospitals Association of Kenya (RUPHA) has officially lifted its boycott of the Social Health Authority (SHA) services after the government committed to settling outstanding National Health Insurance Fund (NHIF) arrears.
However, the group has vowed to continue its suspension of services under Medical Administrator Kenya Limited (MAKL), citing unresolved financial concerns.
RUPHA’s decision follows President William Ruto’s directive to begin clearing NHIF debts, including an immediate payment of all claims below Kshs 10 million.
The move is expected to provide relief to 88% of affected healthcare providers, particularly Level 2, 3, and 4 hospitals.
While the directive marks progress, RUPHA emphasized that it does not fully resolve all financial challenges facing private healthcare facilities.
The association has proposed an upfront payment of Kshs 10 million for facilities owed more than this amount to prevent further financial strain while awaiting claim verification.
Despite progress on SHA payments, RUPHA is maintaining its suspension of MAKL services due to what it describes as a “complete lack of action” from the medical administrator.
The association outlined several unresolved issues, including:
- Unreconciled Debts: Hospitals are unable to track outstanding balances due to a lack of reconciliations.
- Opaque Payment Processes: MAKL has not issued remittance advice for payments, leaving hospitals in the dark about what they are owed.
- Unilateral Discounts: The administrator continues to impose deductions of 10-30% on invoices without explanation or provider consent.
RUPHA is calling on MAKL’s underwriters, Minet and CIC, to intervene immediately and address these grievances.
While RUPHA has agreed to resume SHA services, it has warned that it will not hesitate to reinstate its boycott if the government fails to honor its commitments.
The association has set clear expectations, including timely payments for claims under Kshs 10 million, expedited verification for larger claims, and resolution of MAKL-related concerns.
“If payments are delayed, if the verification process stalls beyond 90 days, or if MAKL continues its exploitative financial practices, we will escalate our response, including legal and regulatory action,” RUPHA said in a statement.
The association has also pledged to monitor government payments closely and engage with Parliament to ensure that healthcare providers are treated fairly in future budget allocations.
For now, private hospitals in Kenya will resume SHA services, but with a watchful eye on whether the government delivers on its promises.
