SHA theft probe: Health Ministry hands over 1,188 fraud files to DCI
This comes amid revelations that MoH withdrew inspectors from the ground and resorted to online application of claims without physical verification on the existence of health facilities and claims made thus exposing the systems to grave abuse and manipulation by insiders in collusion with unscrupulous health facility operators
The Ministry of Health has formally handed over 1,188 case files and supporting evidence to the Directorate of Criminal Investigations (DCI) for further investigation and prosecution of widespread fraud within the Social Health Authority (SHA) that has undermined patient care and depleted public resources.
This comes amid revelations that MoH withdrew inspectors from the ground and resorted to online application of claims without physical verification on the existence of health facilities and claims made thus exposing the systems to grave abuse and manipulation by insiders in collusion with unscrupulous health facility operators.
Among those expected to be questioned are SHA senior officers and top ministry officials who colluded to make payments to ghost facilities alongside representatives of the flagged health facilities over falsified claims.
This follows an intensive forensic review and a comprehensive digital audit that led to the closure of 1,300 health facilities implicated in fraudulent or non-compliant practices.
According to the ministry, among the offenses uncovered include upcoding, falsification of records, conversion of outpatient services into inpatient claims, and phantom billing.
Duale announced the creation of a multi-agency investigation team comprising officers from the DCI, Ministry of Health, Social Health Authority (SHA), Kenya Medical Practitioners and Dentists Council (KMPDC), and the Digital Health Agency (DHA) to strengthen accountability.
“The team will ensure that all offenders whether health facilities, providers, or patients face the full force of the law, while fast-tracking recovery of public funds and advancing the rollout of Universal Health Coverage (UHC),” Duale said through an update made on MoH X handle.
Further, the CS Duale who has come under intense criticism over failure to stem blatant theft highlighted the Ministry’s cutting-edge AI-powered fraud detection system, built on a big data engine under TaifaCare.
The system monitors every transaction in real time, detecting suspicious patterns and blocking fraudulent claims before disbursement.
He urged Kenyans to support the crackdown by reporting suspected fraud through SHA’s toll-free line 147.
The press briefing was attended by senior officials, including PS Dr. Ouma Oluga (Medical Services), PS Ms. Mary Muthoni (Public Health and Professional Standards), Inspector General of Police Douglas Kanja, DCI Director Mohamed Amin, DIG Gilbert Masengeli, and CEOs Dr. Mercy Mwangangi (SHA), Dr. David Kariuki (KMPDC), and Eng. Anthony Lenayara (DHA), among others.
