Hospitals directed not to turn away emergency cases after SHA cover suspension
RUPHA said new admissions under SHA or Medical Administrators Kenya Limited will only proceed if the cover provider guarantees upfront payment.
The Rural & Urban Private Hospitals Association of Kenya (RUPHA) has directed hospitals to honour all inpatient admissions and scheduled outpatient appointments made before February 24 ahead of the planned suspension of Social Health Authority (SHA) services from Monday, February 24.
RUPHA said new admissions under SHA or Medical Administrators Kenya Limited (MAKL) will only proceed if the cover provider guarantees upfront payment.
More To Read
- Crisis looms as Ombudsman gives SHA seven days to settle Sh30bn hospital arrears
- Clinical officers’ union boss claims cartels in defunct NHIF now sabotaging SHA implementation
- Unresolved SHIF challenges leave Kenyans frustrated as system failures hinder access to healthcare services
- NHIF shutdown: Only 815 out of 1,737 employees to join SHA
Hospitals under RUPHA have announced they will halt services funded by SHA and MAKL starting Monday due to outstanding claims. The association has issued new guidelines on how healthcare facilities should manage the transition while ensuring patient care is not compromised.
"Emergency cases shall not be denied care under any circumstances," RUPHA said in a communiqué on Sunday, directing hospitals to stabilise all critical patients before referring them to facilities that still accept SHA or MAKL cover.
Once stabilised, patients who choose to exclusively rely on their SHA or MAKL medical covers will be referred to a hospital of their choice.
Hospitals have also been instructed to communicate the changes professionally at the point of care rather than through public notices or social media. Front desk staff are required to offer alternative payment options or refer patients to facilities where SHA and MAKL services are still available.
“Patients seeking SHA or MAKL services after February 24 shall be informed at the service point that the cover is temporarily unavailable,” the association said.
The hospitals must document all cases where service delivery is affected due to SHA or MAKL funding constraints. Hospitals have been cautioned against direct confrontations with state agencies, with RUPHA advising them to escalate disputes through the association for resolution.
Report any external pressure
RUPHA reaffirmed its commitment to pursuing payments for previously rendered services through legal and arbitration mechanisms. It urged hospitals facing external pressure to continue SHA and MAKL funded services without financial assurances to report such instances for intervention.
The association maintained that the suspension is a protective measure to safeguard healthcare providers from financial strain while ensuring patients are not left without care.
RUPHA Chairperson Brian Lishenga accused the government of failing to honour its financial obligations, forcing hospitals to suspend SHA services. According to Lishenga, hospitals have been struggling with debts dating as far back as 2017.
The association criticised the government for relying on SHA contributions from Kenyans to resolve the debt crisis instead of allocating funds through a supplementary budget.
“I was speaking to some insiders. They told me they spoke with the president, who categorically said there is no money,” Lishenga revealed.
“SHA authorities have been shut down consistently and told there is no money. The fallback was to register as many people as possible, hoping there would be an SHA windfall that would cover NHIF deficits. They were hoping the SHA money would be a lot.”
Despite the impasse, RUPHA added that it remains open to discussions should the government present a concrete plan to address the delayed payments.
Top Stories Today
