RUPHA Orders Cash Payments from SHA Patients For Private Hospitals After Government Fails to Pay Billions
The Rural and Urban Private Hospitals Association of Kenya (RUPHA) has instructed all private hospitals to demand cash payments from Social Health Authority (SHA) beneficiaries starting September 22, 2025, citing government debts.
This comes after weeks of frustration over unpaid bills from National Health Insurance Fund (NHIF) and SHA. RUPHA says the delayed payments have left many facilities struggling to operate and are now forced to take drastic measures.
In a statement, the association said patients under SHA will now have to pay cash for treatment unless otherwise specified by individual hospitals. RUPHA noted that this is regrettable but necessary to keep hospitals open, medical supplies available and staff delivering care.
“We regret the inconvenience this may cause but this is vital to keep hospitals open and safeguard the delivery of essential health services,” the association said.
The standoff with the Ministry of Health escalated earlier this month when RUPHA issued a 14-day go-slow notice, demanding immediate clearance of NHIF arrears and at least 50% of the outstanding Ksh43 billion SHA debts. RUPHA pointed to a presidential directive issued in March 2025 to clear NHIF debts which has not been fulfilled.
RUPHA Chairperson Brian Lishenga has warned that if the government does not act fast, many private hospitals will shut down by December 2025. He added that the sector is burdened with a whopping Ksh76 billion debt – Ksh33 billion from NHIF and Ksh43 billion from SHA.
“The health sector cannot carry this burden any longer. If the government does not pay up, the reality is that by December, private hospitals will either collapse or operate entirely on cash basis,” Lishenga said.
The association said while they regret the inconvenience to patients, this was done in the interest of survival. Many private hospitals have warned that if debt is not settled immediately, access to healthcare for millions of Kenyans will be severely disrupted.
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RUPHA Orders Cash Payments from SHA Patients For Private Hospitals After Government Fails to Pay Billions