Patients under the Social Health Authority (SHA) will get SMS confirmations once claims have been paid to their respective hospitals, the government has announced.
In a statement on Wednesday, February 26, 2025, State House Spokesperson Hussein Mohamed revealed that the practice will start on March 1, 2025.
“Effective 1st March, 2025, patients will be getting an SMS Message once the hospital receives payment related to their treatment. There will be no one to mislead,” Mohamed said.
According to Mohamed, SHA has signed contracts with over 15,000 public and private hospitals, and their claims should be paid within 90 days. However, he says the authority is currently paying claims within a month.
“SHA has contracted over 15,000 Facilities in the Public and Private Sectors. The signed contracts stipulate that all claims are paid within 90 days. Notwithstanding this provision, SHA has been paying claims every end month. All SHA Claims upto 31st January have been fully paid,” he added.
Mohamed says some claims under the defunct National Hospital Insurance Fund (NHIF) were dubiously created during the transition to SHA to create non-existent liabilities.
“Regarding the old debts owed to Facilities by the defunct NHIF, whereas some of the claims are genuine, it has come to the attention of the relevant authorities that some claims were pushed through as we came close to the transition to SHA in order to create liabilities. The investigative agencies are seized of the matter and soon the wheat will be separated from the chaff and necessary action will be taken,” Mohamed added.
“Taifacare remains steadfast in our determination to clean up the Healthcare system and no amount of intimidation will derail us from this noble cause to provide quality healthcare in line with Article 43 of the Constitution.”
SHA-RUPHA crisis
His remarks come amid a biting crisis, pitting SHA and the Rural & Urban Private Hospitals Association of Kenya (RUPHA).
Hospitals under RUPHA have temporarily suspended services under SHA insurance scheme and Medical Administrator Kenya Limited (MAKL) due to unresolved payment issues.
The suspension took effect on Monday, February 24, 2025, according to guidelines issued to member hospitals by the body on Sunday, February 23, 2025.
Ksh30 billion debt
On Thursday, February 20, 2025, RUPHA revealed a Ksh30 billion debt owed by the government to the hospitals, which has made operations difficult.
“The Rural & Urban Private Hospitals Association of Kenya (RUPHA), representing hundreds of private and faith-based healthcare facilities nationwide, announces today (Thursday, February 20, 2025) a suspension of services under the Social Health Authority (SHA) insurance scheme beginning Monday, 24th February 2025.
“As healthcare professionals, our first duty is the welfare of our patients. However, the continued failure to address critical challenges in the SHA transition is now directly endangering the quality and sustainability of care in our hospitals. This decision has not been made lightly,” the RUPHA statement read.
RUPHA added that they have had engagements concerning SHA and two issues emerged making it impossible to continue treating patients who are covered by the scheme.
“It follows months of failed engagements, unfulfilled promises, and growing financial distress among hospitals, which now threatens the very survival of healthcare institutions across Kenya.
“Despite numerous engagements with government authorities, two critical issues remain unresolved, making it impossible to sustain operations: Settlement of historical NHIF arrears Amounting to Kshs 30 Billion and rejection of the Unworkable SHA Outpatient Reimbursement Model,” the statement added.
Crisis
RUPHA added that hospitals have been struggling majorly because of unsettled debts that amount Ksh30 billion.
“Kenyan hospitals across all ownership categories—public, private, and faith-based—are struggling under the weight of unpaid claims dating back to 2017, with the total amount now exceeding Kshs 30 billion.
“The consequences of this financial neglect are dire: massive job losses—many hospitals have lost doctors, nurses, and support staff due to inability to pay salaries; bank defaults—hospitals have defaulted on loans and overdrafts used to sustain operations while awaiting payments.
“Stockouts of essential medicines—pharmaceutical suppliers have blacklisted hospitals that cannot clear outstanding bills.
“Unpaid specialist doctors—many consultants have gone unpaid for years due to delayed reimbursements,” it concluded.
RUPHA also said that they will stop treating teachers and police officers amid the crisis around SHA.
Francis Muli
Francis Muli is a passionate digital journalist with over seven years of experience in crafting compelling stories across various platforms. His major focus is in business, politics and current affairs. He brings a keen eye for detail and a commitment to uncovering the truth.
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