NAIROBI, Kenya, Oct 4 — The Directorate of Criminal Investigations (DCI) has arrested five suspects in connection with ongoing investigations into fraud allegations at the Social Health Authority (SHA).
The arrests are linked to files forwarded by both SHA and the Kenya Medical Practitioners and Dentists Council (KMPDC).
In a statement issued Friday, the DCI said the arrests followed intensive scrutiny of 1,188 files received from the two agencies on September 1, 2025.
The files reportedly contained details of individuals, organisations, and entities suspected of engaging in healthcare fraud — activities that threaten the integrity of government efforts to deliver quality healthcare services to Kenyans.
“A multi-agency team, led by the DCI, was formed to conduct a comprehensive review of the materials,” the agency said.
“The aim is to ensure that all individuals involved in any form of healthcare fraud are held accountable for their actions.”
The five suspects are currently in custody and are expected to be arraigned in court on Monday, October 6.
According to the DCI, the suspects will face multiple 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.
More arrests
The agency added that more arrests are expected as investigations continue, with approvals from the Office of the Director of Public Prosecutions (ODPP).
“The DCI remains resolute in its commitment to combating healthcare fraud, holding offenders accountable, and, in collaboration with other law enforcement agencies, ensuring that all assets and resources acquired fraudulently are recovered,” the statement said.
The Directorate further urged members of the public to support efforts to safeguard the healthcare system by reporting suspicious activities through its toll-free hotlines.
The development comes as SHA faces heightened scrutiny over corruption allegations and the management of public funds under the new social health insurance framework.
On September 9, Medical Services Principal Secretary Ouma Oluga admitted that the scheme was facing “massive fraud” barely a year after it began processing hospital claims.
Oluga said some little-known hospitals — including those allegedly linked to influential individuals — had received millions of shillings for questionable services, sparking public outrage.
“There are legitimate concerns because of transparency. For the first time in our history, you can go online and see how much each hospital has been paid. But that outrage should also be credited to us for releasing that information,” he said.
A media exposé a few weeks ago revealed that several small facilities with limited capacity had been paid millions, raising fresh questions about loopholes in the system.
Official ministry data indicates that between 28 and 35 percent of medical claims in Kenya may be fraudulent — ranging from inflated invoices to payments for non-existent services.