President William Ruto has issued a warning to healthcare facilities attempting to exploit the newly established Social Health Authority (SHA).
Speaking in London on Wednesday, July 2, Ruto revealed that more than 1,000 medical facilities have already been shut down for engaging in fraudulent activities.
“The criminal elements that are staining SHA will not succeed. We have tracked and closed over 1,000 medical facilities engaging in fraud. More are on the way," he said.
Despite the challenges, Ruto insisted that the new healthcare program is working, highlighting its rapid uptake and growing success.
“Our Social Health Authority is working. In eight months, the transformative medical scheme has served more than 4.9 million people, way above what NHIF would have managed," he added.
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Ruto's remarks came barely a week after the Ministry of Health issued a warning over the rise in fraudulent activities targeting SHA.
In a statement on Sunday, June 29, Health Cabinet Secretary Aden Duale condemned a series of malpractices, warning that those involved will face severe consequences.
"We have noted with great concern a growing trend of fraudulent activities being perpetrated by some healthcare facilities, healthcare workers, and even patients against the Social Health Authority (SHA) Fund.
"These actions are illegal, unethical, and a direct betrayal of the trust placed in our health system," the statement read.
Among the serious violations cited are facilities that convert outpatient claims into inpatient ones in order to inflate bills.
"Some facilities are fraudulently converting outpatient claims into inpatient claims. This is a serious offense. Any facility found engaging in this malpractice will be shut down immediately and prosecuted," the statement continued.
Duale also raised alarm over forced admissions, warning that anyone found engaging in such a practice will be held personally accountable.
"Reports indicate that some facilities are coercing health workers to admit patients unnecessarily to increase claim values. This is unacceptable. Facilities and health workers found colluding in this practice will face disciplinary and legal action.
"Every health worker is reminded to adhere to medical best practices. Both individual practitioners and facility owners will be held personally accountable for any fraudulent activity," the statement added.
Duale highlighted the impact of these scams on efforts to achieve universal health coverage.
"Fraud against the SHA Fund undermines universal healthcare efforts and harms every Kenyan. We will not hesitate to take strong and swift action against any individual or institution found culpable. Let this serve as a final warning," he concluded.
