The Ministry of Health and the Council of Governors have reached an agreement on new Social Health Authority (SHA) contracts for county health facilities, resolving key disputes over county involvement, claims payments and regulatory compliance.
The deal was reached on Monday, October 5, 2026, at Afya House in Nairobi during a meeting attended by the Ministry of Health, governors, SHA, the Digital Health Agency and health regulators.
The agreement sets out how county facilities will be contracted under SHA’s 2026–2029 contracting cycle while allowing services and claims to continue during the transition.
Under the new framework, providers will sign one Master General Terms and Conditions agreement, followed by separate contracts for the funds through which their services are purchased.
These include the Primary Healthcare Fund, Social Health Insurance Fund, Emergency, Chronic and Critical Illness Fund, and Public Officers Medical Scheme Fund.
Each county facility will retain its own contract, while payments will continue to be made through its Facility Improvement Financing account.
County governments will be recognised as contracting parties, with facilities required to obtain approval from the County Executive Committee Member for Health. County Attorneys will also review and clear the contracts before signing.
SHA will accept county-level documents when contracting public facilities, including proof of ownership, KMPDC licences, Kenya Master Health Facility List registration, county KRA PIN and tax compliance certificates where applicable.
County NSSF and data protection compliance certificates will also be accepted where they cover the relevant facilities.
Level 4 and 5 facilities must submit their latest audited financial statements, while audited county financial statements will apply to Level 2 and 3 facilities and qualifying Level 4 facilities that have never been audited.
Facilities must also have official email addresses using facility-specific sub-domains of county domains.
The Digital Health Agency will assist counties without registered domains to obtain the required sub-domains before October 14.
On claims, SHA said properly delivered and validly submitted claims will be paid.
Clean claims must be settled within 90 days, with unpaid claims becoming certified liabilities and carried forward as the first charge on the next appropriation.
SHA will notify facilities where payments are delayed because of insufficient funds.
However, payments remain subject to funds appropriated by Parliament, while the Social Health Insurance Regulations, 2024 do not provide for interest on claims.
Existing SHA contracts have been extended to October 14 to allow facilities to complete the new contracting process, with no further extension planned.
A 30-day compliance moratorium will apply to outstanding NSSF, NEMA, fire safety, NCPWD and ODPC documents.
Facilities meeting other requirements may be contracted conditionally and given 30 days to submit the missing documents.
However, laboratory, pharmacy and imaging licences from KMLTTB, PPB and KNRA will remain mandatory for Level 4 and 5 facilities where applicable.
A Joint Technical Committee comprising SHA, the Council of Governors and county health departments will oversee implementation and resolve emerging issues.
SHA will meet County Executive Committee Members for Health on October 6 and conduct HAKIKA contracting clinics across the counties between October 5 and 14.
The Authority will also issue weekly county-by-county updates until all eligible facilities are contracted.
The Council of Governors will support Level 5 hospitals to complete their transition to HMIS by October 30.
The Health Cabinet Secretary and Council of Governors will review implementation before October 14 and continue consultations on any outstanding issues.
