Private hospitals face license revocation over SHA compliance

Principal Secretary for the State Department of Medical Services Harry Kimtai when he appeared before the National Assembly's Departmental Committee on Health on February 10, 2025. (Photo: MoH)

By Maureen Kinyanjui
Tuesday, March 18, 2025

PS Kimtai criticised hospitals that have halted services, accusing them of using the situation to pressure the government.

Private hospitals in Kenya face the possibility of losing their licenses if they fail to comply with the Social Health Authority (SHA) regulations, Medical Services Principal Secretary Harry Kimtai has warned.

He stressed that these facilities must operate within the law and continue offering services to Kenyans.

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The PS on Monday criticised hospitals that have halted services, accusing them of using the situation to pressure the government.

“Why do you protest? Why do you stop service when you knew well that NHIF had your outstanding bill? Since 2016, we have called for negotiations and engagement to prove that it is true. We were ready to pay, but they should not blackmail the government and Kenyans by stopping to offer services,” Kimtai said.

He further warned that failure to comply could lead to license revocation.

“If they continue like this, it is obvious; that they are also subject to renewal of licenses. If they are not compliant and don’t want to offer services to Kenyans according to the laws, then close shop; that is not the right business that you are supposed to do,” Kimtai added.

Private hospitals have urged the government to clear outstanding National Health Insurance Fund (NHIF) arrears before processing SHA claims.

The Rural and Urban Private Hospitals Association of Kenya (RUPHA) and the Kenya Association of Private Hospitals (KAPH) reported that 55 per cent of private hospitals want NHIF payments settled first.

According to a report from the two associations, 26 per cent of private health facilities prefer NHIF and SHA claims to be processed simultaneously, while 19 per cent support prioritizing SHA payments and deferring NHIF arrears.

“Private facilities overwhelmingly prefer NHIF arrears settlement (61 per cent), compared to 51 per cent for faith-based hospitals and 49 per cent for public facilities,” the report stated.

The report also revealed that while 56 per cent of facilities have reconciled their NHIF claims, lower-level health facilities are struggling due to limited awareness and restricted access to the NHIF portal.

Earlier this month, State House announced that hospitals with NHIF claims of Sh10 million and below would be paid in full, covering 91 per cent of contracted facilities.

The remaining nine per cent, with claims exceeding Sh10 million, will undergo a verification process within 90 days before a payment plan is agreed upon.