RUPHA chairperson Dr Brian Lishenga
The Rural and Urban Private Hospitals Association of Kenya (RUPHA) has immediately suspended the use of Social Health Authority (SHA) credit from its facilities, terming it unreliable and unsustainable.
In a press statement, Dr. Brian Lishenga, Chairman, RUPHA (which represents over 700 private and faith-based healthcare facilities across the country) stated that the difficult decision was arrived at after SHA failed to address the pertinent issues they raised.
He said “This difficult decision follows the lapse of the two-week notice issued on 5th September. SHA has failed to address the issues we raised, leaving hospitals in a state of financial paralysis hence putting our patients at risk.”
Key Concerns Raised by RUPHA include breach of contract on claims rejection on August 27, 2025, where the Cabinet Secretary for Health, Hon. Aden Duale, ordered the rejection of medical claims worth Kshs 10.6 billion, without following the due process under Clause 8.2.2 of the SHA Provider Contract.
They argue that this clause requires SHA to communicate, in writing, any rejection of claims within 14 days of receipt, with reasons provided. They claim that many of the claims rejected by the CS were well beyond this window and providers were denied the chance to clarify or remedy concerns which has left hospitals staring at losses.
The statement also raised the concern on the discrimination in claims settlement instead of automated “first-in, first-out” digital adjudication.
“Claim settlements are now plagued by human interference. SHA appears to be The comprehensive care society hand-picking “winners and losers,” creating uncertainty and inequity in reimbursements,” the statement read.
Further, they lamented lamented failure by SHA to settle historical liabilities one year into the SHA transition. They say that their providers are still carrying debts dating back to 2017.
“Through a presidential directive in March 2025, SHA was ordered to immediately pay verified claims worth 10 million shillings and below, but SHA has ignored it.” Dr Lishenga stressed, “there are there are no “NHIF debts” and “SHA debts”—all liabilities are legally owed by SHA.”
To reinstate credit facilities to SHA, RUPHA demands immediate settlement of all claims worth 10M shillings and below, as directed by H.E. the President.
For claims above Sh10 million, verification should begin within 7 days, and payments made without delay where verification is already complete.
It also demands reversal of the mass rejections and opportunity for hospitals to clarify submissions, establishment of an independent dispute resolution tribunal as required by law, urgent review of SHA’s healthcare financing model to reduce overreliance on the salaried few and bring in the informal sector sustainably.
RUPHA also demands halting of migration of teachers’ and Police medical schemes until MINET settles all outstanding liabilities to hospitals. Additionally, these schemes owed significant arrears to the defunct NHIF, which now form part of SHA’s Sh33 billion backlog which must be settled before any migration.
