The Rural Private Hospitals Association of Kenya (Rupha) has given the government 14 days to clear outstanding National Health Insurance Fund (NHIF) debts or face service withdrawal.
In a statement, the association noted that hospitals are struggling as the government has failed to honour a Presidential Directive of March 5, 2025, to settle debts of Ksh10 million and below.
“NHIF liabilities now stand at Ksh33 billion while the Social Health Authority (SHA) owes Ksh43 billion. Together, hospitals are owed Ksh76 billion, an unsustainable debt load,” the statement read.
According to Rupha, some of the biggest debts are owed to public and mission hospitals.
It stated that the Kenyatta National Hospital is owed Ksh 1.58B, Moi Teaching and Referral Hospital Ksh 1.23B, Kenyatta University Teaching, Referral & Research Hospital Ksh 540M, and Nakuru County Hospital Ksh 297M
The association warned that it is unfair to politicize the debt crisis, since it affects both public and private hospitals.
At the same time, Rupha accused SHA of blanket rejection of valid claims, saying hospitals are being denied rightful payments without due process.
“This violates the provider contract, which requires SHA to give feedback within 72 hours and rejection notices within 14 days,” the statement added.
Rupha now says if the debts are not cleared in the next two weeks, hospitals will have no choice but to limit services to NHIF and SHA patients.
On Monday, August 25, Duale exposed fraud at SHA, with investigations uncovering disturbing trends, including upcoding, falsification of medical records, converting outpatient visits into inpatient admissions, and phantom billing for non-existent patients.
He announced a crackdown on facilities defrauding the Authority, further informing that claims worth Ksh10.6 billion had been rejected due to fraudulent activities or non-compliance.
On August 25, Duale stated that since assuming office on April 1, 2025, his ministry has intensified the war against fraud through the introduction of a comprehensive digital system. He revealed that the system utilizes artificial intelligence to flag irregularities and detect anomalies throughout the claims process.
