PS: Private hospitals risk shutdown for denying SHA services

Private healthcare providers refusing outpatient services under the Social Health Authority (SHA) will face severe consequences, including the possibility of being shut down.

Health Principal Secretary (PS) Harry Kimtai stated that the government will not succumb to intimidation by private healthcare providers and insisted that all claims exceeding Sh10 million must be substantiated.

Private hospitals are demanding Sh30 billion in debt owed by the defunct National Health Insurance Fund (NHIF). Some of these facilities have suspended SHA services.

On Monday, the PS warned that private hospitals found guilty of denying services to patients would be deregistered from the SHA.

Kimtai made these remarks during the launch and presentation of digitalisation devices in Embu County, as part of the ongoing efforts to implement the Taifa Care health system.

He assured that SHA was fully operational, with teething problems arising from non-compliance with established guidelines.

The PS pointed to improvements in the benefits package and increased revenue collection as signs of progress within the system. “We are here to guide you through the new Primary Healthcare Model, including the capitation framework and benefits package. It is crucial that the benefits package is displayed in all health facilities for public awareness,” Kimtai said.

He criticised some private facilities for intentionally turning away outpatients to pressure the government into settling outstanding medical claims without proper verification.

He warned that the government would not yield to such tactics and emphasised that any claim exceeding Sh10 million must be fully substantiated with supporting documentation.

The PS also expressed concern over claims dating back to 2016, questioning why they were only now being presented. “Why were these claims not pursued earlier?” Kimtai asked.

The event also marked the rollout of the Health Management Information System (HMIS) with healthcare administrators encouraged to adopt the new digital structure to enhance service delivery.

The PS reiterated the government’s commitment to enhancing primary healthcare services and ensuring accessibility through the SHA.

In Embu County, the government has already disbursed Sh32 million under the SHA programme to cater for 24,000 outpatients. Of this amount, Sh24 million is allocated to public healthcare facilities, while Sh8 million will be allocated to private hospitals participating in the programme.

The allocation of funds to each county is based on the number of people registered under the SHA programme.