SHA to terminate contracts of hospitals that fail to migrate to HMIS portal

Hospitals that fail to meet the Social Health Authority's (SHA) digital system rules could lose their place in the scheme, and a meeting between Health Cabinet Secretary Aden Duale and the governors on October 5 confirmed there is no more time on contracts after October 14.

In a notice on June 30, SHA said providers that fail its requirements for a Health Management Information System, or HMIS, will not be eligible for contracting, renewal or continued participation in its schemes, Kenyans.co.ke reported.

An HMIS is the computer system a hospital uses to manage patient records and billing.

SHA chief executive Dr Mercy Mwangangi put it more bluntly at a stakeholder forum in Nairobi on June 29, when she gave providers three months to connect.

"We will have no option but to decontract non-compliant facilities," she said, according to The Star.

To decontract means to end a facility's contract.

Governors close the door on more time

The Star's Tabnacha Odeny reported that on October 5 Duale met the health committee of the Council of Governors, the body that represents Kenya's county governments, and that the two sides agreed SHA contracts will not be extended beyond October 14.

The committee is chaired by Mombasa Governor Abdulswamad Nassir.

The agreement covers county public facilities, and it came with some relief.

Each keeps its own contract with SHA, and those that meet all other requirements get 30 more days to hand in outstanding papers, such as clearances from the National Social Security Fund and the National Environment Management Authority.

The meeting also agreed that correctly filled claims, which are the bills hospitals send to SHA, will be paid within 90 days of receipt, in the order received.

The governors also committed to helping Level 5 hospitals, which are county referral hospitals, finish the HMIS move by October 30.

The Star's report does not say what happens to a facility that misses that date.

SHA scheduled a meeting with county health executives for October 6, and the sources reviewed do not report its outcome.

Two deadlines, two rules

October 14 is about contracts.

SHA is signing up facilities for its 2026 to 2029 cycle, called HAKIKA, with contracts running from October 1, 2026 to June 30, 2029.

The draft contracts were published on September 8, The Standard reported, and CIO Africa reported that the Ministry launched an online platform for facilities to submit documents, confirm their licences and sign on September 18.

October 30 is about technology.

The sources reviewed do not establish that missing it automatically ends a contract, but SHA's eligibility rule above is the reason the two dates are linked.

Why the change

Before the move, hospitals ran two systems, their own HMIS for daily work and a separate SHA provider portal for sending claims.

Duale said this created extra paperwork and sometimes longer waits for patients, in a statement The Standard reported on October 2.

The new arrangement makes the hospital's own system the main one and connects it to SHA, so information is entered once, as an earlier explainer on this site set out.

The government says the old portal was dogged by late payments, weak checks on patients and fraudulent claims.

These are stated aims, and no results have been reported yet.

Who is ready and who is not

Public hospitals are well ahead.

By the Ministry's figures as of October 1, all 6,427 public facilities at Levels 2 to 4, from dispensaries to sub-county hospitals, have finished.

Four Level 5 hospitals are done and 23 are partway there.

Kenyatta National Hospital in Nairobi and Kenyatta University Teaching, Referral and Research Hospital were expected to finish by the end of the week of October 5, and other Level 6 facilities have until October 30.

Faith-based facilities have further to go. Of 518 contracted ones, 38 had finished as of October 1, Duale said in the Ministry's statement, the Kenya Broadcasting Corporation (KBC) reported.

The one-month extension covers public Level 5 and 6, faith-based and private facilities, with support through October from the Digital Health Agency, the government body that certifies health software.

The Standard reported that 28 private HMIS platforms had been certified by then.

What patients were told

Ahead of the September 30 cutoff, Duale said, "If you have not transferred institutions, you cannot serve a patient in Kenya," Citizen Digital reported on September 29.

The Ministry's statement on October 1 then said no patient would be denied care because their facility had not yet fully moved to HMIS.

Contracts are a different matter. SHA pays only for patients at facilities it has contracted.

Mwangangi said in SHA's notice of October 1 that services to SHA patients continue only at facilities that accept the 14-day extension, and facilities that have not completed the process were told to work with SHA county managers on patients receiving ongoing care, The Standard reported.

Signing up

Mwangangi said facilities must confirm acceptance, sign and return the extension within three days. SHA is running contracting clinics, which are help sessions, in every county from October 5 to October 14.

SHA said on October 1 that 10,006 providers have expressed interest and are at different stages of the process.

On June 12, Capital FM reported that SHA had contracted 11,034 health facilities.

The two figures come from different points in the process, so they are not an exact like-for-like count.

The contracts drew pushback.

The Christian Health Association of Kenya, the Kenya Association of Private Hospitals and the Rural Urban Private Hospitals Association of Kenya, which together represent more than 3,000 facilities, said the first comment deadline of September 10 came two days after the contracts were published on September 8.

They asked for three weeks more, to October 1, and SHA moved the deadline to September 17, The Standard's Mercy Kahenda reported.

The associations also said they understood the contracts had been drafted more strictly partly because of SHA's audit of claims.