RUPHA seeks settlement of billions owed by defunct NHIF after court halted claims verification
In addition to paying facilities owed Sh10 million and below, RUPHA is also seeking publication of intended facility-level settlement amounts within the next two weeks
Rural and Urban Private Hospitals Association of Kenya (RUPHA) now wants Health Cabinet Secretary Aden Duale to formally commit in writing to pay all providers still owed Sh10 million and below by the defunct National Hospital Insurance Fund (NHIF) on or before September 9 following the recent High Court decision that halted verification of pending bills.
In a letter to the CS, RUPHA cited televised remarks he made on July 8 during which he revealed that Sh5.3 billion had been allocated by the National Treasury for the settlement of this category of pending claims within two months, which, it said, means they are due on September 9 or thereabouts.
In the letter, dated 14th August 2025, RUPHA expressed its deep concern regarding the continued delay in the fulfillment of President William Ruto’s directive on March5 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,” it says.
RUPHA noted that the President public acknowledged of the devastating impact of NHIF debt on healthcare delivery and directed the Social Health Authority (SHA) to pay all facilities with NHIF claims of Sh10 million and below in full, representing 91 per cent of contracted facilities; subject facilities owed above Sh10 million to a 90-day verification process, after which a payment plan would be agreed; and that the CS gazettes the verification committee within a week.
In response, Duale 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 August 12, Justice Reuben Nyambati Nyakundi, sitting in Eldoret, declared the verification committee unconstitutional, stating that the Social Health Insurance Act contains no transitional provisions allowing the formation of such committees.
Ruling on a petition filed by Nakuru surgeon Magara Gikenyi and three others, the judge further held that claims verification involving confidential patient information must be conducted solely by staff of the NHIF or SHA.
In addition to paying facilities owed Sh10 million and below, RUPHA is also seeking publication of intended facility-level settlement amounts within the next two weeks.
“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,” the letter to Duale says.
It also wants SHA to immediately settle uncontested claims above Sh10 million for facilities that had completed the NHIF-led claim verification and sign-off process in 2023/2024, noting that no further verification is required.
“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,” the letter adds.
“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.”
