RUPHA Statement on Settlement of NHIF Pending Bills

On behalf of the Rural and Urban Private Hospitals Association of Kenya (RUPHA), we write to express our deep concern regarding the continued delay in the fulfillment of the Presidential directive issued on 5th March 2025 regarding the settlement of NHIF pending bills. As of today, 14th August 2025, it has been 162 days—more than five months—since this directive was issued, yet no healthcare facility—public, private, or faith-based—has received any payment for the NHIF arrears it is owed.

We welcomed the President’s public acknowledgment of the devastating impact of NHIF debt on healthcare delivery and his directive to:

1. Pay all facilities with NHIF claims of Kshs 10 million and below in full, representing 91% of contracted facilities.
2. Subject facilities owed above Kshs 10 million to a 90-day verification process, after which a payment plan would be agreed.
3. Require your office to gazette the verification committee within a week of the statement.

In response, your Ministry established the NHIF Pending Bills Verification Committee through Kenya Gazette Notice No. 4069 of 28th March 2025, to verify claims submitted between 1st July 2022 and 30th September 2024.

However, on 12th August 2025, the High Court in Eldoret declared the committee unconstitutional, stating that the Social Health Insurance Act contains no transitional provisions allowing the formation of such committees. The Court further held that claims verification involving confidential patient information must be conducted solely by staff of the NHIF or SHA.

In the interim, during televised remarks on 8th July 2025, you informed the public that Kshs 5.3 billion had been allocated by the National Treasury for the settlement of all NHIF pending bills worth Kshs 10 million and below, and that these funds would be released within two months—by 9th September 2025 or thereabouts.

OUR REQUESTS

In light of the above, we respectfully request your urgent intervention on the following:

1. Written Commitment to Settle Claims ≤ Kshs 10 Million We ask that you issue a formal written commitment to all providers confirming that verified NHIF claims of Kshs 10 million and below will be settled on or before 9th September 2025, as earlier promised.

2. Publication of Intended Facility-Level Settlement Amounts We request that you instruct the Social Health Authority to, within the next two weeks, publish the pending claim amounts per facility that are earmarked for payment. This transparency will allow providers who may disagree with the listed amounts to file appeals or submit clarifying evidence with their local SHA branches.

3. Settlement of Uncontested Claims > Kshs 10 Million For facilities that had completed the NHIF-led claim verification and sign-off process in 2023/2024, we request that the SHA be instructed to settle these uncontested liabilities immediately, as no further verification is required.

4. Resumption of Internal SHA-Branch Led Verification For facilities that did not undergo the prior NHIF sign-off process, we propose that the SHA be directed to reactivate its internal branch-led claims verification process and complete it within the next three months, in line with the High Court’s guidance.

RUPHA remains fully committed to supporting the Ministry of Health in a constructive and solutions-driven manner. Addressing these long-standing claims will unlock urgently needed working capital across the health sector and advance the goals of Universal Health Coverage (UHC) under the Taifa Care framework.