Government shuts down 31 hospitals for SHA fraud
Health Cabinet Secretary Aden Duale condemned the trend, stating that it undermines public trust in the universal health coverage programme and would be met with swift punishment.
The government has raised an alarm over an increase in fraudulent activities targeting the Social Health Authority (SHA) Fund, warning that individuals and healthcare facilities found culpable will face immediate shutdowns, criminal prosecution and other legal consequences.
On Sunday, Health CS Aden Duale announced the shutdown of 31 private hospitals for unethical practices aimed at siphoning money from SHA.
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Duale cited incidents of ghost patient admissions, forced or unnecessary inpatient admissions, and the misuse of pre-authorisation and patient access codes to claim payments for services not rendered.
Health Cabinet Secretary Aden Duale condemned the trend, stating that it undermines public trust in the universal health coverage programme and would be met with swift punishment.
“Fraud against the SHA Fund harms every Kenyan. We will not hesitate to take strong and swift action against any individual or institution found culpable,” Duale said.
The Authority said it had received reports implicating a number of healthcare workers, facilities, and even patients in acts of fraud. These include coercing health workers to admit patients unnecessarily to increase claim values, sharing of patient access codes with hospitals to fraudulently claim services not rendered, and the misuse of pre-authorisation codes by doctors.
“We have noted with great concern a growing trend of fraudulent activities being perpetrated by some healthcare facilities, healthcare workers, and even patients against the SHA Fund. These actions are illegal, unethical, and a direct betrayal of the trust placed in our health system,” Duale said in a statement.
The Authority added that facilities claiming to have admitted ‘ghost’ patients or operating beyond their approved physical capacity will be shut down immediately and their operators prosecuted. It also flagged cases of double billing, where some hospitals were demanding cash payments from patients while also charging the Fund for the same services.
Duale reiterated that every health worker is expected to adhere to professional standards, and any doctor or facility owner involved in fraud will be held personally accountable.
“Such conduct violates professional ethics and the law. We will not tolerate it,” he said.
Patients have also been urged to be vigilant and to avoid participating in fraudulent claims. The Authority noted that sharing access codes or enabling false billing is criminal and will attract prosecution. To prevent abuse, patients are encouraged to verify charges using the Afyangu app.
The SHA has urged members of the public to report any suspected fraud by dialling *147# and following the prompts. The government has assured Kenyans that it will protect the integrity of the SHA Fund and will not allow a few individuals to sabotage the national health insurance reform efforts.
“Let this serve as a final warning,” the Authority said.
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