Private hospitals to accept cash-only payments for medical services over Sh29bn govt debt

Healthcare providers in Kenya are facing a growing crisis as the government continues to delay the payment of Sh29 billion owed to them by the now-defunct National Health Insurance Fund (NHIF).
Starting January 1, 2025, hospitals under the Rural and Urban Private Hospitals Association of Kenya (RUPHA) will require patients to pay cash for medical services due to the mounting financial strain caused by unpaid debts.
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Addressing the media on Monday, Dr Brian Lishenga, the chairperson of RUPHA, voiced his frustration with the government's failure to honour its obligations, stating that the outstanding debt is crippling the operations of many private healthcare facilities.
"Hospitals are struggling, with some laying off staff because they cannot sustain paying them with empty coffers," he said.
"Unless there is a substantial move to settle NHIF liabilities, from January 1, hospitals will move to out-of-pocket payments. We have no other way to keep the facilities open."
The Sh29 billion debt stems from services provided to patients under the NHIF before it transitioned to the Social Health Authority (SHA).
In October, Medical Services Principal Secretary Harry Kimtai promised that the government would clear all outstanding NHIF debts within 90 days.
Financial distress
However, healthcare providers argue that the payment process has not been expedited, and many hospitals are now facing severe financial distress.
According to RUPHA, the transition to the SHA has worsened the situation. The government has also reduced capitation amounts for hospitals, leaving them struggling to cover their operational costs.
"We are now engaged in a war of words... to end this confusion, we are demanding that the NHIF portal be reopened. We have no access to it yet our claims that have been there since 2019 cannot be accounted for," Lishenga added.
The closure of the NHIF portal, which contained records of healthcare providers' claims, has left hospitals in a state of limbo.
RUPHA's members argue that without access to the portal, they cannot verify or track the claims that have been pending for years, with some dating back to 2019.
The Social Health Authority's transition committee has acknowledged the debt but claims that the government owes only half of the total amount demanded by the hospitals.
As the deadline for cash-only payments approaches, private healthcare providers are urging the government to act quickly to resolve the issue.
"In the next two weeks, all NHIF liabilities that are owed to hospitals must be reconciled," Lishenga noted.
The move to cash-only payments could severely impact many patients who rely on NHIF coverage, with some fearing they will no longer be able to afford medical care.
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