Twelve health officials, among them eight doctors, are being investigated for allegedly defrauding the Social Health Authority, according to Health Cabinet Secretary Aden Duale.

The officials, based in Nairobi, Bungoma, and Kilifi, are accused of engaging in false billing practices and submitting fake patient claims, with their cases already referred to the Directorate of Criminal Investigations.

Speaking at a press briefing on Friday, Duale said the Ministry of Health will not hesitate to take firm action against anyone found misusing the SHA programme.

“Any doctor or health official involved in defrauding SHA will be held personally responsible,” Duale told reporters.

“We will hand over all the hospitals and the 12 health officials to the DCI for further investigations. Additionally, we have ordered the relevant regulatory bodies to cancel their licenses.”

As part of the ongoing crackdown, the Ministry has suspended 40 hospitals from participating in the SHA scheme. The suspensions take effect immediately and will remain in place while investigations continue.

Duale outlined some of the fraudulent activities uncovered, including the manipulation of outpatient cases into inpatient ones, especially in Nairobi and Homa Bay, and claims filed for patients who never existed.

“In Mandera County, four different facilities submitted claims for the same patient who was only admitted to one facility,” he said.

He warned that hospitals found to have made false claims will be required to repay the money they received.

“These facilities will not receive any benefits from SHA during the investigation period, and we will recover the money lost,” he said.

The Ministry also plans to publish the names of all the suspended hospitals in an official Gazette Notice after the investigations are complete.

The SHA programme was introduced to improve healthcare access and streamline funding, but recent concerns have emerged over abuse of the system. Duale said the government will not spare any individual or institution found responsible for misusing public health funds.

“This behaviour undermines the integrity of our health system and robs deserving Kenyans of essential services. We will not tolerate it,” he said.

The action by the Ministry signals a push to restore public trust in the healthcare system and reinforce accountability among providers.

As part of the ongoing crackdown, the Ministry has suspended 40 hospitals from participating in the SHA scheme