{"id":121103,"date":"2025-09-09T10:09:07","date_gmt":"2025-09-09T10:09:07","guid":{"rendered":"https:\/\/chezaspin.com\/blog\/index.php\/2025\/09\/09\/ps-oluga-admits-sha-facing-massive-fraud-a-year-after-it-started-paying-claims\/"},"modified":"2025-09-09T10:09:07","modified_gmt":"2025-09-09T10:09:07","slug":"ps-oluga-admits-sha-facing-massive-fraud-a-year-after-it-started-paying-claims","status":"publish","type":"post","link":"https:\/\/chezaspin.com\/blog\/ps-oluga-admits-sha-facing-massive-fraud-a-year-after-it-started-paying-claims\/","title":{"rendered":"PS Oluga admits SHA facing massive fraud a year after it started paying claims"},"content":{"rendered":"

NAIROBI, Kenya, Sep 9 \u2013 Medical Services Principal Secretary Ouma\u00a0 Oluga has admitted that the new social health insurance scheme (SHA) is facing massive fraud barely a year after it began paying hospital claims.<\/strong><\/p>\n

Oluga said little-known hospitals some linked to influential figures have received millions of shillings for questionable services, sparking public outrage.<\/p>\n

\u201cThere 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 the outrage should also be credited to us for giving out that information,\u201dOluga said.<\/p>\n

A recent media expos\u00e9 revealed that facilities with limited capacity were paid millions, a development that has raised questions about loopholes in the new system.<\/p>\n

Ministry figures suggest that 28 to 35 percent of medical claims in the country are fraudulent, ranging from inflated bills to ghost services.<\/p>\n

The ministry has shut down 728 health facilities and downgraded 301 others in a sweeping crackdown.<\/p>\n

\u201cSome facilities claimed to be Level 4 hospitals when they were not,\u201d Dr. Oluga said.<\/p>\n

\u201cThey would present high-end equipment and specialists during inspection, then remove them once licensed. That is why we acted.\u201d<\/p>\n

He said rogue facilities are suspended immediately once irregularities are confirmed, with files forwarded to the Directorate of Criminal Investigations (DCI) for prosecution.<\/p>\n

Despite the scandal, the PS defended Social Health Authority as a step forward in openness.<\/p>\n

\u201cFor 62 years under NHIF, no one ever saw a hospital\u2019s claim payments,\u201d he said.<\/p>\n

\u201cThis is the first time in the world you can go online and see those figures.\u201d<\/p>\n

PS Oluga highlighted that the ministry\u2019s hotline, which receives about 3,000 calls a day, has become a key tool in flagging fraudulent claims and poor service.<\/p>\n

The Medical Service PS warned that fraud is not only institutional but also reflects a wider societal problem.<\/p>\n

\u201cIt is criminal, yes, but it is also cultural.Hospitals register with equipment and top doctors to get licensed, then move them elsewhere. Patients are charged KSh1,500 for Panadol that should cost KSh30. This is everyday fraud,\u201d he said.<\/p>\n

He said reforms are being tightened to lower costs and enforce accountability but cautioned that true change requires a shift in values.<\/p>\n

\u201cAs we point fingers at government, we must also point fingers at ourselves,\u201d he said.<\/p>\n

\u201cWe need people who love this country enough to stop cheating it.\u201d<\/p>","protected":false},"excerpt":{"rendered":"

NAIROBI, Kenya, Sep 9 \u2013 Medical Services Principal Secretary Ouma\u00a0 Oluga has admitted that the new social health insurance scheme (SHA) is facing massive fraud barely a year after it began paying hospital claims. Oluga said little-known hospitals some linked to influential figures have received millions of shillings for questionable services, sparking public outrage. \u201cThere […]<\/p>\n","protected":false},"author":0,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-121103","post","type-post","status-publish","format-standard","hentry","category-uncategorized","entry"],"jetpack_sharing_enabled":true,"jetpack_featured_media_url":"","jetpack-related-posts":[],"_links":{"self":[{"href":"https:\/\/chezaspin.com\/blog\/wp-json\/wp\/v2\/posts\/121103","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/chezaspin.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/chezaspin.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"replies":[{"embeddable":true,"href":"https:\/\/chezaspin.com\/blog\/wp-json\/wp\/v2\/comments?post=121103"}],"version-history":[{"count":0,"href":"https:\/\/chezaspin.com\/blog\/wp-json\/wp\/v2\/posts\/121103\/revisions"}],"wp:attachment":[{"href":"https:\/\/chezaspin.com\/blog\/wp-json\/wp\/v2\/media?parent=121103"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/chezaspin.com\/blog\/wp-json\/wp\/v2\/categories?post=121103"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/chezaspin.com\/blog\/wp-json\/wp\/v2\/tags?post=121103"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}