SOCIAL HEALTH AUTHORITY OUTLINES NEW COMPLIANCE REQUIREMENTS FOR HEALTHCARE PROVIDER CONTRACTS
NAIROBI, KENYA — The Social Health Authority (SHA) has formally released strict operational, statutory, and digital compliance prerequisites that all public, private, and faith-based healthcare facilities must meet to secure delivery contracts for the upcoming 2026–2029 operating cycle. The new frameworks, established pursuant to the Social Health Insurance Act, mandate medical institutions across all 47 counties to undergo rigorous vetting before entering formal service delivery agreements.
The upcoming contracting period—running from October 1, 2026, to June 30, 2029—will govern provider participation across all four newly structured statutory health funds: the Primary Health Care Fund (PHCF), the Social Health Insurance Fund (SHIF), the Emergency, Chronic and Critical Illness Fund (ECCIF), and the Public Officers Medical Scheme Fund (POMSF).
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CENTRALIZED E-CONTRACTING AND DIGITAL INFRASTRUCTURE
Under the updated guidelines, all health facilities must complete registration and inspection verification exclusively through SHA’s centralized digital portal (provider.sha.go.ke). The authority has emphasized digital integration as a key prerequisite for credentialing.
Facilities seeking active contracts must demonstrate full compliance with Health Management Information System (HMIS) integration standards. Healthcare providers are required to link their internal Electronic Medical Record (EMR) systems directly with the Digital Health Agency (DHA) infrastructure to enable real-time claim processing, patient verification, and automated billing audits.
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STATUTORY MANDATES AND COMPLIANCE CHECKLIST
To eliminate fraudulent claims and safeguard public health resources, SHA requires all participating medical institutions to submit comprehensive regulatory and financial documentation:
* Regulatory Licensing: Valid, unexpired operational facility licenses issued by relevant regulatory bodies (e.g., Kenya Medical Practitioners and Dentists Council).
* Professional Credentials: Proof of valid active licenses and professional registration for all medical practitioners employed on-site.
* Financial Integrity: A current Tax Compliance Certificate (TCC) from the Kenya Revenue Authority (KRA) and verified institutional bank details for direct e-payment settlements.
* Governance Disclosures: Completed beneficial ownership declarations and signed anti-fraud commitments aimed at curbing fictitious claims.
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REVIEW DEADLINE & IMPLEMENTATION TIMELINE
Recognizing the technical adjustments involved in the new contracts, SHA CEO Dr. Mercy Mwangangi extended the feedback window for hospital associations—including RUPHA, CHAK, and KAPH—to submit contract reviews ahead of final executions. The extended review window closes on September 17, 2026, keeping the official contract launch strictly on track for October 1, 2026.
