Crisis looms as Ombudsman gives SHA seven days to settle Sh30bn hospital arrears

RUPHA, citing the crippling financial strain, announced that its members would no longer offer credit-based services due to the government's failure to remit payments.
The Office of the Ombudsman, also known as the Commission on Administrative Justice (CAJ), has issued a seven-day ultimatum to the Social Health Authority (SHA) to explain outstanding hospital payments, following a warning by the Rural and Urban Private Hospitals Authority (RUPHA) to suspend healthcare services starting Monday, February 24.
In a statement on Friday, the CAJ outlined five key demands for SHA, including a detailed breakdown of unpaid claims and reasons for the prolonged delays.
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The directive comes amid growing frustration from private healthcare providers over unpaid arrears inherited from the now-defunct National Health Insurance Fund (NHIF), which total approximately Sh30 billion.
RUPHA, citing the crippling financial strain, announced that its members would no longer offer credit-based services due to the government's failure to remit payments under the previous health insurance system.
"Hospitals have been auctioned, employees have been lost, and specialists are refusing to work. Doctors will only treat patients who pay in cash," the association stated.
In response, CAJ has tasked SHA, led by Chief Executive Officer Robert Ingasira, with developing a clear plan to settle outstanding payments and prevent further delays.
The Ombudsman also called for an independent audit of SHA's financial operations to determine the cause of the funding shortfall, despite the government regularly disbursing billions for healthcare payments.
To address the looming crisis, CAJ demanded that SHA disclose the grievance resolution mechanisms it has put in place to mitigate the impact on hospitals and patients.
Additionally, SHA must provide evidence of consultations with RUPHA and other stakeholders to resolve the standoff.
As the deadline looms, the Ombudsman urged SHA to prioritise settling arrears to ensure uninterrupted healthcare services.
Meanwhile, Health Cabinet Secretary Debora Barasa acknowledged RUPHA's concerns, stating that the ministry would engage stakeholders in discussions to find a solution.
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