Five suspects will appear in court on Monday over alleged fraud at the Social Health Authority (SHA) involving false hospital claims.

The Directorate of Criminal Investigations (DCI) confirmed the arraignments on Friday, saying they followed weeks of reviewing files submitted by Health Cabinet Secretary Aden Duale.

“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,” DCI said in a statement.

More Suspects to Follow

The agency revealed that it is investigating 1,188 files linked to possible healthcare fraud, with more arrests expected.
“Thorough and expedient investigations were immediately initiated upon receipt of the files. A multi-agency team, led by the DCI, was formed to conduct a comprehensive review,” the statement read.

The five suspects face charges 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.

How the Fraud Worked

According to the Health Ministry, facilities implicated in the scheme engaged in multiple fraudulent practices. These included billing for costlier procedures than were performed, falsifying medical records, inflating outpatient visits to inpatient admissions, and making claims for patients who never existed.

On 1 September 2025, the DCI received the 1,188 case files from SHA and the Kenya Medical Practitioners and Dentists Council (KMPDC) after public complaints about widespread fraud.

The files were divided into three categories:

• Category 1: 24 facilities where fraud was confirmed.

• Category 2: 61 facilities with ongoing investigations.

• Category 3: 105 cases earlier closed by KMPDC but still contracted by SHA.

KMPDC also forwarded 998 files of facilities suspected of violating medical regulations.

Next Steps

Investigators are now tracing assets and resources believed to have been acquired through fraudulent means, with more prosecutions expected in the coming weeks.