State to pay all hospitals claiming Sh10m and below

Social Health Authority (SHA) headquarters in Nairobi

The government will pay in full all hospitals claiming Sh10 million and below from the National Health Insurance Fund (NHIF), the State House has announced.

In a statement to newsrooms, the government said the amount will represent 91 percent of all facilities that were contracted by NHIF.

The State House added that the remaining nine per cent of hospitals, with total claims of above Sh10 million, will be subjected to a verification exercise that should be completed within 90 days after which a payment plan will be agreed on.

It said the Cabinet Secretary for Health Deborah Barasa will gazette the verification committee within a week.

The government acknowledged NHIF debts have been a heavy burden on healthcare facilities and providers for the past 10 years.

“This has had a devastating effect on the provision of health services in public, faith-based, and private hospitals,” the statement said.

It added that by the time the NHIF was wound up on November 22, 2024, it had a debt of Sh33 billion, affecting the ability of health facilities to provide services under the Social Health Authority (SHA).

The government added that under SHA, current claims will continue to be paid within a month.

“To date, SHA has paid all undisputed claims lodged by since its inception on October 1, 2024, and up to January 31, 2025, totaling Sh18.2 billion.”

The government said it remains fully committed to providing Universal Health Coverage to every Kenyan without discrimination.

“I would like to assure all Kenyans that any challenges being experienced in the implementation of Taifa Care are being attended to and resolved,” the statement read in part.

On March 4, 2025, private health facilities asked the government to first settle NHIF arrears before SHA claims.

Rural and Urban Private Hospitals Association of Kenya (RUPHA) and Kenya Association of Private Hospitals (KAPH) told the Departmental Committee on Health of the National Assembly that 55 per cent of the facilities want NHIF arrears to be considered first.

In a report to the committee, RUPHA and KAPH said data from health service providers show 26 per cent of private facilities prefer simultaneous payment of both NHIF and SHA claims.

They said 19 per cent support prioritising SHA claim payments while deferring NHIF arrears.