DCI takes over 1,188 health fraud files handed in by SHA and KMPDC

The Directorate of Criminal Investigations has taken over 1,188 files from the Social Health Authority and the Kenya Medical Practitioners and Dentists Council detailing suspected cases of healthcare fraud.

The files, which also involve individuals and healthcare entities, are expected to guide investigations into malpractice and irregular activities within the sector.

The DCI said it has formed a multi-agency team to fast-track the review of the cases. According to the agency, the objective is to ensure that anyone implicated in fraudulent schemes is prosecuted, regardless of their social or political standing.

“In collaboration with all other law enforcement agencies, we are committed to recovering all assets and other resources acquired through fraudulent means. The public will be kept informed on the progress of the investigations through regular updates,” the DCI stated on Monday.

The agency further assured that it will remain central in supporting both government and non-governmental institutions in the fight against fraud, while also urging Kenyans to report such crimes.

Health Cabinet Secretary Aden Duale confirmed that the files had been handed over, describing the step as a key milestone in addressing fraud in the health sector.

He said the files target facilities and individuals suspected of non-compliance and fraudulent dealings.

“This action targets fraudulent and non-compliant healthcare facilities and individuals, marking a critical milestone in the ongoing effort to protect public funds and safeguard the integrity of Kenya's healthcare system,” Duale said.

The CS noted that the documents contain detailed evidence to support possible prosecution and stressed that the government is determined to curb health sector fraud, protect resources, and restore trust in medical institutions.

According to the ministry, the submission of the files follows joint action by the SHA, KMPDC, and the Clinical Officers Council. The bodies had been carrying out forensic audits and digital system checks which uncovered serious malpractices in the sector.

Duale disclosed that the Social Health Authority had already suspended 85 healthcare facilities to pave the way for investigations.

“SHA, in line with its mandate, has suspended a total of Eighty-Five (85) health facilities for fraudulent activities to allow for investigations,” he stated.

The CS warned that the fraudulent practices uncovered not only drain resources but also directly harm patients. He highlighted three main schemes that rogue providers have been using to exploit the system.