SHA Cover Stays, but Hospitals Will Handle Billing Through Their Own Systems

A visit can now be written once. That is the change a patient can use. SHA, the insurer that replaced the National Hospital Insurance Fund, is not being replaced by a system called HMIS.

Health Cabinet Secretary Aden Duale said so in a Ministry of Health statement on 1 October 2026. The CS stated the move is from the SHA provider portal to the Health Management Information System.

It is not a new insurance scheme, and the Ministry said it is not the introduction of a new system. The work sits inside the already funded digital superhighway rollout.

What the patient still has

SHA remains the cover. HMIS is the hospital file: the admission, the consultation, the procedure, the medicine and the bill. Since SHA was set up, the Digital Health Agency has given hospitals a portal for claims. Hospitals were already running their own system for the day's work. Staff sometimes typed the same visit into both. The Ministry said that second entry added paperwork and slowed processing.

Under the new arrangement, the hospital system is the main record and the channel to SHA. A claim is meant to be built from the treatment that was captured, which the Ministry says should make a duplicate or inconsistent claim easier to see. Duale said the point was to clarify what had been in place, what is changing, and how the link is expected to change delivery.

The line that matters at the desk is in the same statement. No patient will be denied care because a facility has not finished the move. Services continue during the transition.

The bill, and where the delay sits

For a household, the card does not change and the contribution does not move to a new scheme. The money risk is on the hospital side. A claim that sits between two systems is a payment that has not reached the facility. A facility waiting on that payment is the one that starts asking for cash at the counter. The Ministry has not published a total for claims stranded by this switch.

A separate Sha notice, dated 28 September 2026 and also carried by Nairobi Leo, moved the verification dates for old NHIF claims at Level 4 facilities where the pending file is 10 million shillings or more. That exercise is about defunct NHIF files. It is not the HMIS deadline. The two queues can still meet in the same accounts office.

Who has finished, according to the Ministry

The 1 October statement put the count like this: All 6,427 public Level 2 to 4 facilities had completed the move. Four public Level 5 hospitals had finished, and 23 were still in progress. Of 518 contracted faith-based facilities, 38 had completed the transition.

Kenyatta National Hospital and Kenyatta University Teaching, Referral and Research Hospital were expected to finish the following week. Other national Level 6 facilities were given until 30 October. The Digital Health Agency had certified 28 existing private HMIS platforms under the Digital Health Act.

The date, and the help on offer

Facilities that had not finished were given until 30 October 2026. The Ministry called it an additional one-month extension. The Digital Health Agency is running Rapid Results Initiatives through October for technical help, and facilities were told to ask for that help rather than wait. The Ministry was also due to meet health-sector associations on 2 October to agree facility-by-facility plans.

The test is ordinary. If the link works, the counter needs less repeat paperwork and the hospital's claim is cleaner. If it does not, 30 October only moves the queue. SHA is still the insurer. HMIS is still the hospital file.