The Social Health Authority (SHA) has outlined the requirements healthcare providers and facilities must meet as it prepares to begin a new contracting cycle on October 1, 2026.

🇰🇪 Breaking It Down

The new contracting cycle will run until June 30, 2029, with SHA preparing agreements that will govern its engagement with healthcare providers and facilities across the country.

In simple terms, contracting is the process through which SHA collects and reviews information about a healthcare provider before formally entering into an agreement with the facility to provide services covered under the health insurance system.

SHA said the process involves the submission and review of provider information, regulatory documents and other requirements before a contract can be finalised.

📌 What You Need to Know

“Providers will be onboarded through the Centralised Digital Platform, supported by the submission of the required documents and information for assessment. The process will also involve regulatory validation, know-your-customer verification, technical assessment and financial due diligence,” SHA stated.

The new framework will cover contracts under four funds the Primary Health Care Fund (PHCF), Social Health Insurance Fund (SHIF), Emergency, Chronic and Critical Illness Fund (ECCIF), and Public Officers Medical Scheme Fund (POMSF) for the period running to June 30, 2029.

Under the proposed framework, the PHCF contract will set out the terms and obligations for providers and facilities delivering primary healthcare services covered under the fund.

Healthcare facilities will also be required to demonstrate digital readiness, including having a functional electronic medical record or approved claims system to support digital contracting and claims processes.

In addition, facilities must also be able to submit claims electronically, have internet-accessible devices at points of care and designate an administrator responsible for managing the facility's activities on the digital platform.

Among the documents providers are expected to have ready are a valid facility licence, valid professional registrations, a beneficial ownership declaration and a valid tax compliance certificate.

📰 Source: Kenyans.co.ke