The government has announced that 45 health facilities risk being struck off the register after being flagged for fraudulent activities.
In a statement issued on August 25, 2025, Health Cabinet Secretary Aden Duale said investigations into the facilities will begin soon. This follows the suspension of 40 other facilities by the Social Health Authority (SHA) earlier this month.
According to the CS, audits have uncovered widespread fraud, including billing for procedures that were never carried out, falsifying medical records, charging inpatient fees for simple outpatient visits, and submitting claims for non-existent patients. He said these actions go against Section 48(5) of the Social Health Insurance Act, 2023 and Regulation 34(2)(f) of the Social Health Insurance Regulations, 2024.
Some of the facilities singled out include Nabuala Hospital in Bungoma, accused of making false claims for multiple Caesarean sections on the same patient. Kotiende Medical Centre in Homa Bay was cited for fabricating clinical records with one person signing off both day and night shifts. In Nairobi, Vebeneza Medical Centre allegedly turned outpatient visits into inpatient claims, while Jambo Jipya Hospital in Mtwapa is accused of submitting fraudulent Caesarean section claims when patients had normal deliveries. New Manyalo Nursing Home in Wajir is also under investigation for admitting more patients than its bed capacity and making duplicate claims for patients admitted in other facilities.
Other facilities flagged for collusion include Al-Masry Nursing Home, Rhamu Dimtu Medical Centre, Balanga Medical Center, Care Connect Hospital, Al Shamsi Medical Centre, Merti Nursing Home, Zamzam Nursing Home, and Nibil Nursing Home. These facilities are accused of jointly submitting over 300 fraudulent claims for patients allegedly admitted on the same dates across different facilities.
“To all healthcare providers: consider this a final warning. We are watching. Any facility, doctor, or patient found to be involved in fraudulent activities will be held liable and face the full force of the law. We’ve already initiated the process to recover paid monies and will involve law enforcement to prosecute perpetrators,” Duale said.
He further urged Kenyans to remain vigilant and report suspicious activities.
“Please work with us to ensure that every cent of public money is used prudently for its intended purpose: to provide legitimate, quality healthcare to all. Report any concerns or information regarding fraudulent activities to SHA through the toll-free number 147. Your participation is vital in protecting our social health insurer and securing a healthier future for our nation.”
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