Duale flags Mandera, Kisii, Migori, Homa Bay and Wajir as SHA fraud ‘epicentres’

 

Health Cabinet Secretary Aden Duale has said the government has shut down more than 1,200 health facilities and escalated dozens of investigation files to prosecutors as it intensifies a crackdown on alleged fraud involving the Social Health Authority (SHA) and the defunct National Hospital Insurance Fund (NHIF).

Appearing before the Senate on Wednesday morning, Duale said the Director of Public Prosecutions (DPP) had received more than 24 case files, and that at least 18 of them — including files involving two former CEOs of SHA and NHIF — had already been taken to court.

He added that investigations had also affected staff of SHA and NHIF, as well as some regulatory bodies.

“As we sit here, the DCI has close to 81 files, of which last week he has submitted 24 more files to the DPP,” Duale said, adding that the ministry would not relent in fighting fraud.

Duale cited Bungoma West Hospital and 13 Calvary Hospital facilities in Bungoma among those shut down as part of the crackdown.

He also named five counties — Mandera, Kisii, Migori, Homa Bay and Wajir — as areas flagged as “epicentres” of fraud, saying the probe targets both counties and individual facilities.

The CS said most of the alleged fraud was taking place in private health facilities.

He further told senators the ministry was rejecting suspicious or unsupported claims, saying claims worth 13 per cent of what he put at $1.2 billion had been rejected so far.

Duale said the tighter scrutiny was also aimed at reducing fraud and claim rejections through stricter documentation, giving an example of maternity claims that are rejected if a birth notification is missing.

“The only thing that can tell us a child has been born is if you produce a legal document called birth notification,” he said.

Duale appealed to leaders to support the anti-fraud drive and stop calling him to intervene when facilities are closed, saying he would not “barge” on suspected fraud cases.

He claimed the crackdown had triggered “noise” because, he said, some facilities were used to stealing from specific schemes, including teachers’ benefits, adding that he planned to meet teacher union leaders to reassure them.