Kenya's SHA hospital-contract deadline expires Wednesday, risking care for millions

Kenya's Social Health Authority (SHA) has told hospitals and clinics that their current provider contracts expire at 11:59pm on Wednesday, 30 September 2026, and that any facility without a signed contract for the new 2026–2029 cycle will be locked out of the SHA provider portal and barred from treating SHA beneficiaries from Thursday, 1 October.

In a notice dated 28 September, SHA chief executive Dr Mercy Mwangangi said: "Providers without an executed contract for the 2026-2029 cycle will not be permitted to offer services to SHA beneficiaries after that date, and their access to the SHA provider portal will be switched off." Facilities that miss the deadline have been told to arrange for patients receiving ongoing care to be transferred to contracted providers to avoid interruptions to treatment.

What is at stake

SHA, the successor to the former National Hospital Insurance Fund (NHIF), had 32.3 million registered members as of August 2026 — nearly double NHIF's peak enrolment of 16.9 million, according to Mwangangi. Under the outgoing contracting cycle, 10,713 facilities were contracted with SHA as of August: 5,959 government, 4,534 private and 541 faith-based, the authority told a National Health Summit in Nairobi.

The new contracting framework, known as HAKIKA, was launched on 18 September alongside a digital e-contracting platform and runs until 30 June 2029. It covers four funds: the Primary Health Care Fund, the Social Health Insurance Fund, the Emergency, Chronic and Critical Illness Fund, and the Public Officers Medical Scheme Fund.

Hospitals push back on terms

Private and faith-based hospital associations — including the Rural and Urban Private Hospitals Association of Kenya (RUPHA), the Christian Health Association of Kenya (CHAK), SUPKEM and the Kenya Association of Private Hospitals (KAPH) — have raised roughly 40 objections to the draft contract, according to The Standard. Disputed clauses include one allowing SHA to delay reimbursement depending on fund availability while requiring hospitals to keep treating SHA members, and a method for extrapolating error rates from sampled claims across larger batches, which hospitals say lacks a statutory basis.

"We shall not be forced to get into contracts whereby SHA decides when to pay or when to [not]," a hospital consortium representative told The Standard, adding that providers expect payment within set timelines.

SHA had already extended an earlier feedback window on the draft terms from 10 to 17 September, after RUPHA, CHAK and KAPH — representing more than 3,000 facilities, about 85 percent of them small and medium-sized providers with limited in-house legal capacity — said two days was not enough time to review what they called "materially revised terms, obligations and risk allocations." Health Cabinet Secretary Aden Duale has directed hospitals to sign by 1 October while welcoming further negotiation; The Standard reported that Duale cast the new system as moving hospitals and SHA from a transactional relationship toward a partnership. Mwangangi, however, has indicated the 30 September cut-off itself will not move.

Where things stand

As of 27 September, 7,244 facilities had submitted Expressions of Interest for the new cycle, according to Pulse Kenya — a preliminary step that does not amount to an executed contract. That is roughly two-thirds of the 10,713 facilities contracted under the outgoing cycle, suggesting a significant number may still be uncontracted when the deadline passes.

The lockout applies only to patients relying on SHA cover; hospitals can continue treating walk-in, cash-paying patients regardless of their contract status. But for the millions of Kenyans — and foreign residents, including Chinese workers and NGO staff, who are enrolled as SHA beneficiaries — the practical question this week is whether their regular clinic has signed. SHA has urged beneficiaries and providers with queries to contact its toll-free line, 147, or the SHA provider portal directly.

SHA has not announced any extension of the Wednesday deadline as of the time of publication.