The Directorate of Criminal Investigations (DCI) has taken over 1,188 healthcare fraud case files from the Social Health Authority (SHA) and the Kenya Medical Practitioners and Dentists Council (KMPDC) in a major crackdown on fraudulent practices within the health sector.
According to Health Cabinet Secretary Aden Duale, the cases involve hospitals and clinics accused of upcoding, falsifying medical records, billing for non-existent patients, and misclassifying outpatient cases as inpatient.
Breakdown of the Files
Out of the 1,188 case files:
-
SHA submitted 190 files.
-
KMPDC submitted 998 files.
The review further revealed that:
-
24 facilities have conclusive evidence of fraud.
-
61 facilities remain under active investigation.
-
105 facilities have already been closed by KMPDC.
Multi-Agency Team Formed
DCI has formed a multi-agency team to probe the cases. The unit will work closely with SHA, KMPDC and the Clinical Officers Council to fast-track investigations and ensure prosecution of those involved.
Authorities have also pledged to recover assets acquired through fraudulent means and prosecute suspects regardless of their political or social standing.
https://x.com/HonAdenDuale/status/1962535890133078269
Restoring Trust in the Health Sector
CS Duale said the move is meant to safeguard public funds and restore confidence in the healthcare system. He added that the ministry is committed to ending fraudulent activities that have affected service delivery in hospitals across Kenya.
“This is an important step in ensuring accountability in the health sector. Those found culpable will face the full force of the law,” Duale said.
The crackdown follows months of forensic audits and digital reviews by SHA and KMPDC, which uncovered massive irregularities in claims and billing by some health facilities.
What Next
The DCI team is expected to begin interrogations and audits of the implicated facilities in the coming weeks. More arrests and closures are anticipated as the investigations progress.
Leave a Reply