State shuts 12 hospitals over SHA fraud claims

Health Cabinet Secretary Aden Duale has announced the closure of 12 health facilities since March 30, 2026, as the government steps up its crackdown on fraud within the Social Health Authority (SHA).

Duale made the announcement on April 5 in Garissa, where he said the affected facilities were shut down over suspected double billing and submission of claims for services that were never provided to patients.

"Since March 30, 12 facilities have been shut down over alleged fraud, with 24 currently under forensic audit and 250 under investigation by the Directorate of Criminal Investigations," the CS said.

The closures bring the total number of health facilities shut down in connection with SHA fraud to over 1,000 since the crackdown began.

Duale said the latest round of shutdowns is focused on what he described as areas where irregular claims have been consistently reported under the SHA system.

Investigators have also uncovered a pattern in which some facilities are suspected of working with SHA insiders to push through fraudulent claims, pointing to concerns about collusion within the authority itself.

Thirty case files have been forwarded to the Office of the Director of Public Prosecutions (ODPP), and 18 facilities are already facing charges in court.

The move is part of a multi-agency operation that brings together the DCI, the Ministry of Health, SHA, the Kenya Medical Practitioners and Dentists Council (KMPDC) and the Digital Health Agency.

The crackdown follows the suspension of Bungoma West Hospital for 90 days on March 30, after SHA CEO Dr Mercy Mwangangi determined that preliminary investigations had found the facility had submitted claims for procedures not carried out.

Bungoma West was barred from admitting SHA patients, processing pre-authorisations and receiving payments during the suspension period.

The government's anti-fraud campaign has been running alongside growing pressure from hospitals that are voluntarily pulling out of SHA arrangements, citing unpaid claims and delays in reimbursements.

Several private facilities have in recent days informed patients that they are no longer accepting SHA cover due to unresolved disputes with the insurer.

SHA replaced the National Hospital Insurance Fund (NHIF) in October 2024 as the government's vehicle for delivering Universal Health Coverage.

The scheme has since been dogged by revelations of large-scale fraud, including payments made to facilities that do not exist and claims filed for ghost patients.

Duale said the government would not pay fraudulent claims and that all facilities and individuals found culpable would be prosecuted.

"Reaffirming my mandate to deliver Universal Health Coverage, I declare zero tolerance for the misuse of public health funds and underscore my commitment to safeguarding every cent meant for the care of Kenyans," he stated.

Kenyans can report suspected SHA fraud through the authority's toll-free number, 147.