DCI Forms Multi-Agency Team to Investigate SHA Health Fraud Cases

DCI Forms Multi-Agency Team to Investigate SHA Health Fraud Cases

The Directorate of Criminal Investigations (DCI) has launched a major probe into widespread fraud within the Social Health Authority (SHA).

On Monday, September 1, Health CS Aden Duale handed over 1,188 files to the DCI. The files contain names of individuals, entities, and facilities suspected of defrauding Kenyans through SHA.

In a hard-hitting statement, the DCI confirmed immediate action.

“The Directorate of Criminal Investigations (DCI) wishes to inform the public that it has today received 1,188 files from the Social Health Authority (SHA) and the Kenya Medical Practitioners and Dentists Council (KMPDC),” the statement read.

Multi-Agency Team Formed

The DCI revealed that a multi-agency team had been set up to review the cases quickly.

“Upon receipt of the files, a multi-agency team has been constituted under the leadership of the DCI with a view to expeditiously reviewing the files. The objective of this review is to make sure that all those who have been involved in any form of healthcare fraud will be arraigned regardless of their social status and political affiliations,” the statement added.

Officials assured Kenyans that assets acquired through fraud would also be recovered. Regular updates will be shared with the public to maintain transparency.

Duale Hands Over Files

Health CS Duale confirmed that SHA investigations had been ongoing for months. He explained that the files fell into three categories.

Category One contained 24 health facilities with proven fraud. Category Two listed 61 facilities with active cases, while Category Three carried 105 cases earlier closed but still tied to SHA contracts.

KMPDC contributed 988 of the 1,188 files, exposing facilities running without licences or ignoring regulations.

How the Fraud Worked

According to the ministry, some facilities billed for expensive procedures never performed. Others converted outpatient visits into fake inpatient admissions. Shockingly, some even claimed payments for services offered to non-existent patients.

If convicted of falsifying records, owners risk fines of up to Ksh2 million, suspension, or deregistration under the Social Health Insurance Act, 2023.

Operating without licences or hiring unregistered doctors could attract penalties of up to Ksh10 million or five years in jail.

Countrywide Impact

The revelations come days after KMPDC shut down 544 health facilities and revoked licences of 454 hospitals for breaching SHA standards.

For many Kenyans, the expose confirms long-held fears of exploitation in the health sector. The crackdown promises accountability but also raises urgent questions about patient safety.

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DCI Forms Multi-Agency Team to Investigate SHA Health Fraud Cases