The Social Health Authority (SHA) has suspended 45 health facilities across the country from accessing the national social health scheme. The move, announced in a gazette notice dated August 26, is part of ongoing reforms to strengthen accountability in the healthcare sector.
According to the notice, the suspended facilities will not be entitled to any benefits or payments from SHA during the period of suspension. While the authority did not provide specific details on each case, the decision follows a digital audit that flagged widespread malpractices within some providers.
The suspension comes as part of a broader crackdown on fraud and misuse of public health resources. Malpractices uncovered include falsifying patient records, inflating and phantom billing, upcoding, and converting outpatient visits into costly inpatient claims. These actions not only burden the public healthcare fund but also deny Kenyans access to quality and affordable care.
The Ministry of Health has emphasized that fraudulent providers and facilities will face stern consequences, including de-gazettement, prosecution, and recovery of funds obtained through irregular means. The ministry also highlighted that more than KSh 7.7 billion has recently been disbursed to Primary Health Care (PHC), a key pillar of the Universal Health Coverage (UHC) agenda, underscoring the government’s commitment to expanding access to healthcare services.
In addition, SHA has called on the public to actively participate in the fight against fraud by reporting suspected cases through its toll-free line. To reinforce accountability and prevent future misuse, SHA is partnering with leading medical insurers under a Joint Anti-Fraud Action framework. This collaboration is expected to strengthen oversight mechanisms, safeguard public resources, and restore trust in the healthcare sector.
The suspension of the 45 facilities adds to 40 others already cut off earlier, bringing the total number of flagged facilities to 85. The move is seen as a critical step towards ensuring transparency and integrity in the implementation of the Social Health Insurance Fund (SHIF).
By tightening enforcement and penalizing malpractice, the government aims to protect taxpayers’ money, support honest healthcare providers, and advance the broader goal of delivering quality, affordable, and accessible healthcare for all Kenyans.
