Aasai

The Ministry of Health has suspended 40 health facilities across the country after revealing allegations of widespread fraud at the Community Health Authority (SHA), in what the Cabinet Secretary for Health, Hon. Aden Duale has described it as a major threat “to the sustainability of Kenya’s global health coverage agenda. The suspension, announced in Afya House and published in the Kenya Gazette No. 168 of August 7, 2025, follows a month-long expert review of SHA’s digital health system, which reported suspicious claims. 

The CS said the review uncovered a number of fraudulent practices, including: Upcoding: Claiming procedures that were more expensive than those actually False records: Submitting altered medical records to inflate claims. 

Conversion of outpatient visits to inpatient care: Payment for services patients refuse to Multiple billing and false claims: Collaboration between facilities to claim the same patient. The facilities involved include hospitals in Nairobi, Bungoma, Homa Bay, Mandera, Kilifi and other counties. 

The ministry has also revoked access rights to the SHA platform from eight doctors and four clinical officers implicated in the fraud, and to forward their names to the Directorate of Criminal Investigations (DCI) for prosecution. Regulatory bodies — the Kenya Medical and Dental Council and the Clinical Officers Council — have been asked to initiate disciplinary proceedings that could lead to the revocation of licenses. 

The CS stressed that fraudulent activities witnessed under the defunct National Health Insurance Fund will not be tolerated under the SHA. “Any healthcare provider whose details are used to defraud the SHA will be held personally liable,” he said, adding that facilities will be charged to recover funds already paid for false claims.

 Duale urged Kenyans to protect their SHA One Time Passwords (OTPs) and personal information from anyone  , warning that members whose OTPs are used to commit fraud will also be held accountable. He noted that the Ministry has launched biometric authentication at levels 4, 5, and 6 to prevent misuse of OTPs, with expansion of Level 2 and 3 facilities planned. The Ministry encourages the public to report suspected fraud directly to SHA via the toll-free number 147. “We remain steadfast in safeguarding every shilling contributed by Kenyans to ensure that it provides legitimate, quality health care,” the CS said. 

He reiterated President William Rutos stern warning to health sector fraudsters that any misconduct will be dealt with firmly and according to the law. "If you are trying to game the system, beware: You are already on our radar. The system is reporting such attempts, and investigations are ongoing," Ruto said during the high-profile launch of the National Equipment Service Project at State House, Nairobi, on August 7, 2025. "In due course, the results will be made public, and fraudsters will face the consequences of their criminal acts," the President added. Translation by Lingvanex.com