The Directorate of Criminal Investigations (DCI) has opened a sweeping probe into alleged healthcare fraud after receiving 1,188 incriminating case files from the Social Health Authority (SHA) and the Kenya Medical Practitioners and Dentists Council (KMPDC).
DCI’s Director of Liaison and Corporate Communications, John Marete, confirmed that the files implicate doctors, clinics, and health institutions accused of siphoning funds through ghost patients, inflated bills, and falsified medical reports.
A multi-agency team has already been assembled to review the files “expeditiously” with suspects set to face prosecution regardless of their political or social standing.
“In collaboration with other law enforcement agencies, the DCI is committed to recovering all assets and resources acquired through fraudulent means,” the statement signed by Marete read.
The crackdown gained momentum earlier Monday when Health Cabinet Secretary Aden Duale suspended 85 health facilities following a forensic audit that exposed widespread malpractice. Investigators found evidence of facilities converting outpatient cases into inpatient claims, upcoding procedures to inflate bills, and filing claims for patients who did not exist.
Separately, KMPDC announced sweeping regulatory action, ordering the closure of 544 unlicensed facilities and revoking licenses for 454 more. Inspectors cited grave violations including unqualified staff, lack of critical equipment, and unsafe operating conditions.
In total, SHA forwarded 190 cases while KMPDC handed over 998 cases to the DCI. CS Duale warned that the government will leave no stone unturned in rooting out corruption in the health sector.
“Any facility, doctor, or patient involved in fraud will be brought to book,” Duale declared.
SHA CEO Dr. Mercy Mwangangi added that hospitals under suspension would be cut off from all SHA benefits during their sanction period, a move expected to hit rogue operators financially.
The investigation marks one of the most aggressive government crackdowns on healthcare fraud in recent years, with officials vowing that prosecutions will follow swiftly.
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