Five Kenyans are set to be arraigned on Monday over their alleged involvement in fraudulent hospital claims at the Social Health Authority (SHA).
The Directorate of Criminal Investigations (DCI) confirmed the development on Friday, noting that the suspects were identified following weeks of investigations into files submitted by Health Cabinet Secretary Aden Duale.
According to the DCI, a total of 1,188 files are currently at different stages of investigation, with more arrests expected as the Office of the Director of Public Prosecutions (ODPP) continues to give approvals.
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“We wish to inform the general public that the 1,188 files are at various stages of investigation. Currently, five suspects are in custody pending arraignment on Monday, October 6, 2025. Efforts to apprehend additional suspects are already underway, following approval from the ODPP,” the DCI stated.
The five suspects will face charges under the Penal Code, the Proceeds of Crime and Anti-Money Laundering Act, the Social Health Insurance Act, and the Anti-Corruption and Economic Crimes Act.
The investigation was launched after DCI received 1,188 files from SHA and the Kenya Medical Practitioners and Dentists Council (KMPDC) on September 1, 2025, following widespread complaints of healthcare fraud.
The files detailed fraudulent activities by individuals and organisations believed to have exploited the health sector, including inflated billing, falsification of records, conversion of outpatient visits into inpatient cases, and submitting claims for non-existent patients.
Health CS Aden Duale said the SHA files were classified into three categories: 24 facilities where evidence of fraud had been concluded, 61 facilities with ongoing fraud cases, and 105 cases that had been closed by the KMPDC but still had contracts with the authority.
Meanwhile, KMPDC submitted 998 files of facilities said to be operating in violation of the law.
DCI explained that a multi-agency team was formed to review the materials and investigate assets and resources believed to have been acquired through fraudulent means, with the aim of ensuring all perpetrators are held accountable.
The arraignment of the five suspects marks the beginning of what could be a wide-reaching crackdown on healthcare fraud in the country.