Government Moves to Prosecute 30 Health Facilities Over Suspected Fraud in Social Health Authority Claims
The Directorate of Criminal Investigations (DCI) has completed its probe into suspected irregularities at 30 health facilities and forwarded their case files to the Director of Public Prosecutions for approval to begin legal proceedings.
These facilities are accused of various dishonest practices in their dealings with the Social Health Authority (SHA), the body responsible for managing Kenya’s public health insurance system. The move forms part of a wider effort to protect public funds and ensure the integrity of health services for ordinary citizens.
Investigations revealed several types of wrongdoing, including the creation of false medical records, submission of inflated or incorrect claims, and use of improperly obtained licences or registrations. Some cases involved turning simple outpatient visits into more expensive inpatient claims, while others concerned payments made to facilities that did not have proper agreements with SHA or even to places that did not genuinely exist. Specific examples include unlawful payments linked to certain clinics and nursing homes, particularly in Mandera County, where a number of facilities have already been flagged and suspended.
Health Cabinet Secretary Aden Duale has welcomed the ongoing crackdown, noting that the SHA’s digital systems have helped reduce irregular claims significantly. He pointed out that more than Ksh 12.7 billion in questionable requests have been blocked so far, with no public money lost in the current system. The government has also shut down over 1,000 facilities nationwide as part of this drive, signalling a firm stand against any attempts to misuse the health fund. Officials say these actions aim to strengthen universal health coverage so that Kenyans can access quality care without fear of funds being diverted through dishonest means.
