Seven more files remain under active investigation before being submitted for prosecutorial review.Twenty-four suspects have been charged as investigations continue into alleged fraud targeting the Social Health Authority, the Directorate of Criminal Investigations has said.
In a statement, the DCI said detectives from its Investigations Bureau at headquarters are handling multiple cases linked to healthcare facilities audited by the SHA in Nairobi, Homa Bay, Wajir, Kilifi, Kakamega, Bungoma, Busia, Kisumu, Vihiga and Kajiado counties.
According to the agency, 18 case files have so far been forwarded to the Office of the Director of Public Prosecutions (DPP) for review and legal guidance, with the DPP approving the prosecution of nine cases.
Five additional files are awaiting advice, while three were returned to investigators for further inquiries. Seven more files remain under active investigation before submission for prosecutorial review.
“The DCI remains committed to ensuring accountability and safeguarding public resources,” the agency said, noting that investigations are ongoing.
The cases are part of broader efforts by authorities to address suspected irregularities within the SHA system.
The Ministry of Health has previously reported rejecting claims valued at Sh10.6 billion that it described as fraudulent.
Authorities say the suspected schemes under review include alleged facility-level and individual-level malpractice, such as claims for non-existent patients or facilities, inflated billing, double-claiming, and the misclassification of outpatient services as inpatient care.
Investigators are also examining reports of unnecessary admissions and the alleged misuse of patient access and pre-authorisation codes.
Separately, authorities have cautioned the public about impersonation cases in which individuals allegedly pose as SHA officials during fake registration drives, as well as phishing messages sent to healthcare providers demanding payments for purported documentation processing, which SHA says are fraudulent.
In response to the findings, the Ministry of Health and a multi-agency team say they have shut down or suspended more than 1,000 health facilities over alleged fraudulent or non-compliant practices.
The DCI said 1,188 fraud-related case files have been submitted to the agency.
Measures introduced to strengthen oversight include an AI-powered fraud detection system to monitor transactions in real time and the rollout of biometric verification in major facilities to curb code misuse.
Members of the public have been urged to report suspected fraud through the SHA toll-free line, 147.
President William Ruto has also encouraged Kenyans to report facilities or individuals who demand cash in exchange for services or charge for services that are meant to be provided free at SHA-accredited facilities.
