Duale Presents Over 1,000 Files To DCI: Why Scores Of Kenyans Could Be Arrested
Health Cabinet Secretary Aden Duale said a multi-agency team has been established to pursue the offenders.
Marvin Chege 
The Ministry of Health has transferred 1,188 case files to the Directorate of Criminal Investigations (DCI) in a sweeping crackdown on healthcare fraud, the ministry announced on Monday, September 1.
The cases, backed by forensic evidence, stem from a digital audit that uncovered widespread malpractice in health facilities across the country. As a result, 1,300 facilities were shut down for engaging in fraudulent or non-compliant practices.
Investigators flagged offences including upcoding, falsifying medical records, converting outpatient services into inpatient claims, and phantom billing—schemes that cost taxpayers millions.
Health Cabinet Secretary Aden Duale said a multi-agency team has been established to pursue the offenders.
Officers stand guard at the entrance of DCI headquarters along Kiambu Road. /NATIONAL POLICE SERVICE
The taskforce brings together officers from the DCI, Ministry of Health, Social Health Authority (SHA), Kenya Medical Practitioners and Dentists Council (KMPDC), and the Digital Health Agency (DHA).
"Let me be clear: as previously warned, any facility, doctor, or patient involved in fraud is now under the jurisdiction of our criminal justice system and will be prosecuted to the fullest extent of the law,” Duale said, adding that recovery of stolen funds will be fast-tracked as part of the Universal Health Coverage (UHC) rollout.
The move has sent panic among Kenyans working as medical professionals. Duale revealed that the Social Health Authority (SHA) submitted 190 case files, while the Kenya Medical Practitioners and Dentists Council (KMPDC) handed in 998.
According to Duale, the SHA files were categorised into three groups: 24 facilities where fraud was confirmed, 61 facilities with ongoing fraud investigations, and 105 cases previously closed by KMPDC but involving facilities still contracted by SHA. Meanwhile, the 998 files from KMPDC involved facilities found to be operating illegally.
The CS warned that owners of health facilities found guilty of deliberately falsifying information to defraud the Social Health Authority (SHA) risk fines of up to Ksh2 million, suspension, and removal from the list of accredited providers, as outlined in Section 48(5) of the Social Health Insurance Act, 2023.
He added that individuals running unlicensed facilities or employing unregistered medical practitioners face penalties of up to Ksh10 million or a jail term of up to five years, in line with Section 22(4) and (5) of the Medical Practitioners and Dentists Council Act, CAP 253.
The move follows a recent directive by the KMPDC ordering the closure of 544 health facilities and the withdrawal of licences from 454 hospitals nationwide for breaching SHA regulations.
In a gazette notice issued on Friday, August 29, KMPDC explained that the affected facilities were either unlicensed, unregistered, operating below required standards, or staffed by unlicensed practitioners.
Duale also unveiled the ministry’s AI-powered fraud detection platform, TaifaCare, which tracks all health transactions in real time and blocks suspicious claims before payments are released. He urged the public to help curb malpractice by reporting cases through the SHA’s toll-free line 147.
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