The Directorate of Criminal Investigations (DCI) has provided an update on the progress of ongoing investigations into fraudulent files linked to the Social Health Authority (SHA).
In a statement on Friday, October 3, the agency confirmed that several suspects are already in custody, with more arrests expected in the coming days.
In addition, the DCI revealed that over a thousand files are currently under review.
"We wish to inform the general public that the 1,188 files are at various stages of investigation. Currently, five suspects are in custody pending arraignment on Monday, October 6, 2025. Efforts to apprehend additional suspects are already underway, following approval from the ODPP," the statement read.
According to the DCI, the suspects will face a wide range of charges once arraigned in court.
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"The suspects will be arraigned on various charges, including offences under the Penal Code, the Proceeds of Crime and Anti-Money Laundering Act, the Social Health Insurance Act, and the Anti-Corruption and Economic Crimes Act," the statement added.
In conclusion, the DCI reiterated its determination to fight corruption and healthcare-related fraud, promising to ensure accountability and recovery of stolen assets.
"The DCI remains resolute in its commitment to stopping healthcare fraud, holding all offenders accountable, and, in collaboration with other law enforcement agencies, ensuring that all assets and resources acquired fraudulently are recovered.
"The public will be kept informed on the progress of the investigations through regular updates," the statement concluded.
On Monday, September 1, SHA and the Kenya Medical Practitioners and Dentists Council (KMPDC) handed over more than one thousand files to the DCI for investigations.
In a statement, Health Cabinet Secretary Aden Duale confirmed the move as part of efforts to crack down on fraudulent and non-compliant health facilities across the country.
"The Social Health Authority (SHA) and the Kenya Medical Practitioners and Dentists Council (KMPDC) has today submitted a total of 1188 files and supporting evidence to the Directorate of Criminal Investigations (DCI) - a major step in their joint fight against healthcare fraud.
"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," the statement read.
According to KMPDC, of the 1,188 files submitted, SHA provided 190 while KMPDC delivered 998.
The SHA files were categorized into three groups; 24 facilities where evidence of fraud has already been concluded, 61 facilities still under investigation, and 105 facilities that had been closed by KMPDC but still held contracts with the Authority.
KMPDC’s files focus facilities accused of operating outside the law.
"These submissions are a critical step in a multi-agency collaboration that will see the DCI investigate and prosecute those responsible," the statement added.
According to KMPDC, the schemes under investigation include inflating medical bills by converting outpatient visits into inpatient admissions, falsifying records, billing for procedures never carried out, and submitting claims for nonexistent patients.
"SHA, in line with its mandate, has suspended a total of Eighty-Five (85) health facilities for fraudulent activities to allow for investigations. The rigorous forensic audits and digital system have uncovered deeply troubling patterns of fraud that directly harm the public and deplete the monies meant for patients.
"KMPDC, for its part, and in line with its mandate, has conducted extensive inspections, which recently resulted in the closure of 544 Health Facilities for being unregistered or unlicensed and revocation of operating licenses of 454 health facilities due to a range of violations, including operating below required standards, employing unlicensed practitioners, and lacking critical infrastructure, posing a direct threat to patient health," the statement further read.
KMPDC further noted that SHA has also taken disciplinary measures against individual practitioners linked to fraudulent schemes.
"SHA has already withdrawn user rights for 12 healthcare professionals implicated in criminal schemes and will be surcharging facilities to recover any monies paid based on fraudulent claims. We have a duty to pay only for services legitimately rendered and to hold those who seek to defraud the system accountable," the statement concluded.
