Under the Social Health Authority’s (SHA) 2026‑2029 contracting cycle, hospitals will no longer receive payments simply for being on the contracted list; reimbursement is limited to services that have specific regulatory approval.

Each department must be cleared by its respective regulator – laboratories by the Kenya Medical Laboratory Technicians and Technologists Board, pharmacies by the Pharmacy and Poisons Board, and imaging units by the Kenya Nuclear Regulatory Authority.

Facilities that lack a licence for a particular service can continue operating, but they will be barred from billing SHA for that department, while other licensed services remain reimbursable.

Level 4 and Level 5 hospitals have been given a three‑month window to secure laboratory licences, a requirement now compulsory for continued reimbursement.

The current contracts were extended to 14 October 2026, a deadline the government says will not be moved again, prompting a rapid push to complete licensing and digital contracting.

SHA’s new E‑Contracting Platform now handles applications, document uploads, licence verification, electronic signing and status tracking, with county‑level contracting clinics set up to assist facilities in meeting the deadline.

Facilities that have met all requirements except for certain statutory documents – such as NSSF, NEMA, fire safety, NCPWD or ODPC clearances – receive a 30‑day conditional compliance period, though they must still obtain the missing paperwork.

SHA also introduced a 90‑day payment window for “clean” claims – those that meet all conditions – with any shortfall recorded as a certified liability to be paid within the same financial year, subject to fund availability.

Patients are advised to verify that a hospital is contracted for the specific service they need, as being listed on SHA’s roster alone may no longer guarantee coverage for labs, scans or prescriptions.