Billions in Debt Push Private Hospitals to Halt Credit Services to SHA.

Billions in Debt Push Private Hospitals to Halt Credit Services to SHA.

Dr. Brian Lishenga, Chairman of the Rural & Urban Private Hospitals Association of Kenya (RUPHA), addressing the media at the association’s offices in Lunga Lunga Square, Nairobi.

Nairobi, Kenya – September 20, 2025

The Rural & Urban Private Hospitals Association of Kenya (RUPHA), today at their office in Nairobi, has suspended the provision of healthcare services on credit to the Social Health Authority (SHA), citing mounting unpaid claims, breaches of contract, and unsustainable debt.

The move, announced by RUPHA Chairman Dr. Brian Lishenga, follows the expiry of a two-week notice issued on September 5, 2025. The association, which represents more than 700 private and faith-based healthcare facilities, said the government had failed to address critical concerns raised by providers, leaving hospitals unable to continue underwriting the health insurance scheme.

“SHA is unable to meet its obligations and hospitals cannot continue to accumulate debt while patients suffer,” said Dr. Lishenga. “We must remodel SHA urgently. This is an attempt at survival, not sabotage.”

One of the most contentious issues is the rejection of Kshs 10.6 billion worth of medical claims on August 27, 2025, by Health Cabinet Secretary Hon. Aden Duale. RUPHA says the rejections violated Clause 8.2.2 of the SHA Provider Contract, which requires claims rejection to be communicated in writing within 14 days, with reasons provided.

“Hospitals were denied the chance to clarify or remedy concerns, leaving them with massive losses,” said Dr. Lishenga.

As of August 2025, SHA owes hospitals Kshs 43 billion, with another Kshs 24 billion in claims under review. With SHA raising Kshs 5.4 to 6 billion monthly against claims worth Kshs 8.8 billion, the financing gap is widening at a rate of Kshs 2.4 billion each month.

RUPHA further warned that the planned migration of the Teachers’ worth Kshs 20 billion and Police worth Kshs 8 billion medical schemes to SHA in December 2025 cannot proceed until MINET settles all outstanding liabilities. “Hospitals must not carry over debts from one scheme to another,” the association insisted.

RUPHA also accused SHA of abandoning automated digital adjudication of claims in favor of selective human interference, which they say has created “winners and losers” among providers.

In addition, thousands of beds have been erased through arbitrary downgrades, 3,478 maternity beds, 1,080 delivery beds and over 10,000 inpatient beds have been struck off, severely affecting services in marginalized counties such as Mandera, Turkana, Wajir and Garissa.

“This reckless downgrading has crippled access to healthcare in rural and urban informal settlements where faith-based and private hospitals are the backbone of care,” said Dr. Lishenga.

The hospitals have outlined a set of urgent demands for the reinstatement of credit facilities like Immediate settlement of all claims worth Kshs 10 million and below, as directed by the President in March 2025, verification and payment of claims above Kshs 10 million within seven days where verification is already complete, reversal of the mass rejections of claims and an opportunity for hospitals to clarify submissions, establishment of an independent Dispute Resolution Tribunal under Section 44 of the SHI Act, comprehensive review of SHA’s financing model to reduce overreliance on salaried Kenyans, who currently shoulder 96% of contributions, while the informal sector contributes just 4%, Settlement of historical debts, including arrears from the defunct NHIF, before migrating teachers’ and police medical schemes and reversal of unprocedural downgrades and restoration of erased beds.

Beyond the technical issues, RUPHA called on religious institutions to add their voice to the crisis. “We urge the church to rise to the occasion. SHA must be revived to work, especially as it marks its anniversary. This is not just about hospitals, it is about the survival of healthcare in Kenya,” Dr. Lishenga emphasized.

The association warned that Kenya’s hospitals are on the brink of collapse. Essential supplies are running out, healthcare workers are demoralized, and patients are increasingly being forced to make out-of-pocket payments.

“If private and faith-based hospitals, which provide nearly half of Kenya’s healthcare collapse, Universal Health Coverage will collapse with them. The progress of the last 20 years will be wiped out,” RUPHA said.

The association reaffirmed its willingness to partner with SHA, the Ministry of Health, the Kenya Medical Practitioners and Dentists Council (KMPDC) and the Directorate of Health Accreditation (DHA). However, it insisted that partnership must be built on trust, fairness and respect for the law.