Nairobi, June 30- Health Cabinet Secretary Aden Duale has raised the alarm over a surge in fraudulent activity targeting the newly established Social Health Authority (SHA), warning both healthcare workers and patients against abusing the system.
In a statement issued on Sunday, June 29, Duale revealed that some clinics, medical personnel, and even patients are exploiting loopholes to siphon funds from the SHA—Kenya’s new health financing body that replaced NHIF in October 2024.
“These actions are illegal, unethical, and a betrayal of the trust placed in our health system,” Duale said.
Among the fraudulent practices flagged were:
- Faking hospital admissions to inflate claims
- Converting outpatient visits into inpatient claims
- Using patient codes to claim for services not rendered
- Admitting “ghost patients” who don’t exist
- Billing both SHA and patients for the same treatment
As part of a crackdown, the ministry has closed down 35 private health facilities implicated in the scheme. The affected clinics are spread across Nairobi, Kisumu, Bungoma, Busia, Kilifi, Kajiado, Wajir, and Mandera counties. Duale said the matter has been forwarded to the DCI for investigations, with individual health workers and patients also under review.
The announcement has triggered public debate, with many Kenyans questioning whether SHA has improved on NHIF’s flaws—or simply inherited them. Critics pointed out that the very fraud SHA was meant to prevent is already taking root.
The Ruto administration recently partnered with a Safaricom-led consortium in a KSh104 billion tech deal meant to digitize and secure SHA operations. However, the effectiveness of the system is now under intense public scrutiny.
Duale insisted the government will act decisively: “We will take strong and swift action against any individual or institution found culpable.”
