Dozens of hospitals shut over Sh100m SHA fraud
In some instances, hospitals admitted patients unnecessarily, while others submitted claims for non-existent patients despite already operating at full capacity.
A fresh corruption scandal has rocked Kenya’s public healthcare sector, with at least 35 health facilities, mainly Level 4 and Level 5 hospitals, accused of making fraudulent medical claims to the Social Health Authority (SHA), siphoning off close to Sh100 million.
An internal audit accessed by Citizen TV points to an elaborate scheme where outpatient visits were deliberately disguised as inpatient admissions.
In some instances, hospitals admitted patients unnecessarily, while others submitted claims for non-existent patients despite already operating at full capacity.
The alleged scam implicates not only healthcare providers but also patients, some of whom are said to have willingly shared their personal hospital identification codes to inflate claims.
Three whistle-blowers have already recorded statements with the Ministry of Health, detailing how health workers are pressured to hand over pre-authorization codes used to legitimize fake admissions.
Health Cabinet Secretary Aden Duale, while speaking in Kisumu, confirmed the shutdown of multiple facilities involved in the scandal, including those in Bungoma, Busia, Kilifi, Mandera, Wajir, and Kajiado counties.
“They’re submitting double claims turning outpatient visits into inpatient admissions. I have already closed about seven hospitals here in Kisumu alone,” Duale stated.
“We cannot allow facilities to misuse Kenyans’ identities. Some hospitals have just 14 beds yet falsely claim to have 100.”
The CS warned medical personnel against aiding the racket, adding that facilities implicated in the fraud would be investigated and prosecuted.
“Any medical worker found misusing pre-authorization codes to siphon SHA funds, or any Kenyan aiding the scheme, will be dealt with firmly,” he said. “Tomorrow, I’ll forward several files to the DCI.”
The SHA has reportedly suspended services at the affected hospitals in over ten counties, while the Kenya Medical Practitioners and Dentists Council is in the process of revoking licenses of facilities and practitioners implicated in the misconduct.
