SHA shuts 12 hospitals over fraud, hundreds more under probe
The Social Health Authority building in Nairobi.
Health Cabinet Secretary Aden Duale has announced the closure of 12 hospitals since March 30, following forensic audits by the Social Health Authority (SHA) that flagged the facilities for involvement in fraud.
Speaking in Garissa on Saturday, Duale said more than 1,000 facilities have been closed and hundreds more are under investigation for attempting to illegally claim funds from SHA. Eighteen facilities are already facing court proceedings.
"As the government and the Social Health Authority, through the Bima Ya Kitaifa framework, we have taken the decisive step of closing twelve hospitals effective March 30. These are hospitals, mainly private and public, that the system and SHA forensic auditors flagged for their involvement in systemic and serious fraud," said Duale.
Health Cabinet Secretary Aden Duale (left) and the SHA Headquarters in Upper Hill, Nairobi. The authority lost Sh11 billion in six months.
The CS named Homa Bay, Bungoma, Mandera, Wajir, and Kisii counties as hotspots for the fraudulent schemes, saying private facilities in these counties were the most notorious.
"The crackdown includes Bungoma West Hospital and Calvary Hope Medical Centre in Bungoma, Kerugoya Medical Centre, and various facilities across Homa Bay, Mombasa, and Nairobi. Furthermore, we have suspended five facilities in Mandera and four in Wajir," he said.
Among the affected institutions are Baypharm Medical Centre in Homa Bay, Dawida Annex Hospital Ltd in Taita Taveta, Kerugoya Medical Centre in Kirinyaga, Raycos Health Centre in Mombasa, Calvary Hope Medical Centre and Shamberere Dispensary in Kakamega, Kurafa Medical Centre in Kiambu, and Umoja Three Medical Centre in Nairobi.
The scale of the investigation is broad. Twenty-four facilities are undergoing forensic audits by special SHA investigators, while the Directorate of Criminal Investigations is probing 250 facilities. The Office of the Director of Public Prosecutions has received 30 case files.
On April 3, Bungoma West Hospital was suspended for 90 days over suspected fraudulent claims, including fictitious billing. SHA Chief Executive Officer Dr Mercy Mwangangi suspended the facility from "providing healthcare services to SHA beneficiaries and transacting with SHA for 90 days, pending completion of investigations."
"Your facility shall not admit SHA beneficiaries, process notifications, request pre-authorisations, submit claims or receive payments. SHA is not liable for services rendered during this stoppage without express approval," read a letter from Dr Mwangangi to the hospital's administrator.
Dr Mwangangi further directed the hospital to transfer current SHA beneficiaries to the nearest SHA-contracted facility, notify SHA beneficiaries of the suspension, and cooperate with follow-up investigations.
Duale said his ministry would work relentlessly to protect public funds meant for healthcare.
"To the people of Kenya, let this message be clear. We will remain steadfast in protecting the public resources intended for your healthcare. Whether for the ordinary citizen or the prominent, we are committed to ensuring that every shilling meant for treatment is guarded against corruption and used solely for the well-being of our nation," he said.
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