The Ministry of Health has suspended 40 health facilities across the country following a forensic audit by the Social Health Authority (SHA) that exposed widespread fraudulent activities.

The audit revealed cases of upcoding, falsified records, fake inpatient billing, multiple billing, and the creation of ghost patients to inflate claims.

Speaking during a press briefing on Friday, Health Cabinet Secretary Aden Duale cautioned that “fraud once seen under the defunct NHIF will not be tolerated under SHA,” warning the offenders, drawn from Nairobi, Bungoma, Kilifi, and other parts of the country, will face personal liability and surcharges.

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

Additionally, Duale confirmed that eight doctors and four clinical officers have also been blocked from accessing SHA services and referred to the Directorate of Criminal Investigations (DCI) for prosecution. Regulatory bodies have been engaged to initiate possible licence cancellations for those implicated.

“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.” He added.

In a bid to tighten controls, the ministry will roll out biometric verification in major facilities to curb misuse. CS Duale urged Kenyans to safeguard their SHA one-time passwords (OTPs) and to report suspected fraud through the toll-free line 147.

The crackdown comes amid growing concern over abuse of the SHA programme, which was set up to streamline access to healthcare funding and improve service delivery, with the government resolving to protect public funds and restore integrity in healthcare.