Two months on, government yet to settle NHIF claims for private hospitals despite Ruto promise

Two months on, government yet to settle NHIF claims for private hospitals despite Ruto promise

At the time of NHIF's closure in October 2024, hospitals had raised claims totalling Sh33 billion, accumulated between July 2022 and September 2024.

Nearly two months have passed since promises were made by President William Ruto to settle billions owed to hospitals by the now-defunct National Hospital Insurance Fund (NHIF).

However, both the Kenya Association of Private Hospitals (KAPH) and the Rural & Urban Private Hospitals Association (RUPHA) have expressed frustration, stating they are yet to receive any clear communication regarding their outstanding debts.

In a statement made in March, President Ruto pledged that all claims below Sh10 million would be paid promptly, while claims exceeding that amount would undergo a verification process before payment plans were agreed upon. He also noted that clearing these smaller claims would address the debts owed to 91 per cent of the facilities contracted by NHIF.

“The remaining 9 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,” Ruto said.

Despite this promise, the verification committee, which was set up to handle larger claims, is yet to begin its work.

The committee, led by James Masiro, was formally constituted through a gazette notice on March 28 and was subsequently inaugurated by CS Duale on April 8. However, hospitals remain in limbo, with no further developments in sight.

However, two months later, this promise remains unfulfilled. Dr Eric Musau, Chairperson of KAPH, told The Nation on Friday that hospitals are still in the dark about which claims are to be processed immediately.

"Since the President made the announcement, we have not received any communication from the Ministry of Health. The only information that has come out is the gazetting of the verification committee. It could be the changes in officials at the ministry and the Social Health Authority that are causing the delays," he said.

Musau raised concerns about the ambiguity surrounding the payment process.

"We are currently working on the President's goodwill and are trying to accommodate them. Under the old NHIF system, an invoice would be raised, and the processing office would verify the claim before sending it to the payments office. So, are the claims under Sh10 million the ones in the processing office or the payments office?" he asked.

At the time of NHIF's closure in October 2024, hospitals had raised claims totalling Sh33 billion, accumulated between July 2022 and September 2024.

President Ruto had highlighted the gravity of the situation in his March statement, noting the NHIF's massive debt had significantly hindered the ability of health facilities to deliver services under the new Social Health Authority (SHA).

"The NHIF owed Sh33 billion by the time it was wound up on November 22, 2024, impacting the ability of health facilities to provide services under the SHA," President Ruto said.

In response to the government's delay, faith-based hospitals had initially threatened to halt services unless the debt was settled within 14 days. However, they later withdrew the threat after a meeting with the President.

RUPHA Chairperson, Dr Brian Lishenga, also expressed frustration, stating that his members have been left in the dark.

"We do not know what is happening. The government may be pushing the debt into the 2025/26 financial year, hoping to accommodate it in the Health and Treasury ministries' budgets," he said.

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