Health Cabinet Secretary Aden Duale has dismissed media reports linking the Social Health Authority (SHA) to fraudulent payments and insider dealings.
Responding to a headline by a local newspaper on Monday, August 25, which alleged massive payouts to hospitals associated with government officials, Duale claimed the coverage was part of an attempt to derail reforms.
The outspoken CS insisted that the government will not be distracted from its mission to overhaul the healthcare system.
"No amount of propaganda or blackmail will deter us from fixing our healthcare system. We know saboteurs of SHA have recruited several groups, including some sections of the media, to advance their agenda. Let them be warned: We are fixing this thing regardless of the noise.
"Our work has just begun. We will not rest until every Kenyan has access to quality, affordable, and dignified healthcare, free from the burden of fraud," he said.
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Earlier Monday, Duale dismissed social media allegations that SHA has been making payments to non-existent or non-operational healthcare facilities.
Speaking in a press briefing, he termed the claims as information his ministry already possesses through legitimate channels.
Duale clarified that most facilities being questioned on social media platforms had already been closed, suspended, or downgraded by health regulators in May.
"The facilities you found circulating on social media are facilities that the majority of them were closed in May, and you can check with the regulator's website, or with the DHA, they were closed," he stated.
Duale revealed that regulatory action had been taken against healthcare facilities across multiple counties, including Mandera County, Homabay County, Kisii County, Wajir County, Nairobi County, Bungoma County, and Kisumu County.
At the same time, Duale said audits revealed that some hospitals and clinics have been inflating bills, falsifying records, and submitting claims for services never provided.
He noted that investigators found that certain facilities were engaging in upcoding, where patients were billed for more expensive procedures than those actually performed.
Other institutions were involved in the falsification of records, altering or creating false medical documentation in direct violation of the Social Health Insurance Act and its regulations.
There were also cases where outpatient visits were illegally converted to inpatient admissions, allowing facilities to claim higher reimbursements, and incidents of phantom billing, where services were billed for patients who did not exist.
Duale went ahead to reveal some examples, including Nabuala Hospital in Bungoma, which submitted multiple Caesarean section claims for the same patient in a short period, along with unsupported maternity claims.
Kotiende Medical Centre in Homa Bay fabricated clinical documents, with one person signing off for both day and night shifts over consecutive days.
Vebeneza Medical Centre in Nairobi reportedly converted outpatient visits into inpatient claims and repeatedly admitted its own employees under suspicious circumstances.
Other facilities, including Jambo Jipya Hospital in Mtwapa and New Manyalo Nursing Home in Wajir, submitted fraudulent claims for normal deliveries and exceeded bed capacity by admitting patients already registered elsewhere.
In Mandera, a network of facilities allegedly colluded to submit over 300 claims for patients supposedly admitted on the same dates across multiple locations.
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