RUPHA Demands Urgent NHIF Payments as Hospitals Face Cash Crunch

On August 14, RUPHA issued a statement expressing deep dismay over the lack of progress since President William Ruto’s directive on March 5. While the president had promised full payment for claims KSh 10 million or less and a verification process for larger claims, by mid-August not a single facility public, private, or faith-based had received any NHIF arrears.

This failure in follow-through has deepened the crisis in the healthcare sector. RUPHA’s statement, signed by board member Miriam Wanjiku, emphasized that 162 days over five months had passed since the initial directive with no tangible action to show for it.

RUPHA’s demands are clear and assertive. They ask for a written commitment confirming that all verified claims under KSh 10 million will be paid on or before September 9, 2025. They further call on Cabinet Secretary Duale to direct the Social Health Authority (SHA) to publish pending claim amounts per facility within two weeks and to settle uncontested liabilities from 2023/2024 immediately. Additionally, they urge that SHA should reactivate its internal branch-led claim verification process for facilities without prior NHIF sign-off, within three months.

These demands are set against a backdrop of widespread operational and financial distress. Earlier this year, in February 2025, RUPHA had already warned of hospital shutdowns due to KSh 30 billion in unpaid NHIF arrears dating back several years. The association highlighted that many hospitals had resorted to layoffs, loan defaults, and were struggling with unpaid supplier bills and tax liabilities stemming from reporting claims as income .

The situation is worsened by claims processing dysfunction. Reports indicate that 89% of hospitals faced unreliable access to the SHA claims portal, 54% had received no payments since late 2024, and 83% encountered difficulties verifying patient eligibility delays that are crippling service delivery .

The current impasse threatens more than finances it risks derailing Kenya’s Universal Health Coverage (UHC) ambitions under the Taifa Care framework. Without working capital, many hospitals may be forced to suspend services or turn to cash-only models, disrupting access to care for thousands of Kenyans.

Despite previous attempts at resolution, the verification committee set up to handle claims above KSh 10 million was declared unconstitutional by the High Court in Eldoret. This ruling has blocked any meaningful progress on clearing the backlog of larger claims, leaving even more providers in limbo.

RUPHA insists that its objective is not confrontation but cooperation. In its statement, the association reaffirmed its willingness to work with the Ministry of Health, but stressed that the long-standing claims must be settled to unlock working capital and ensure uninterrupted service delivery across the health sector.

With the September 9 deadline looming, the government now faces a critical decision. Will Cabinet Secretary Duale deliver on the president’s directive with an official commitment, or will hospitals be forced into a further withdrawal of services? The answer may determine the viability of private healthcare providers and the progress of health reforms in Kenya.