Kericho Senator Aaron Cheruiyot has challenged Health Cabinet Secretary Aden Duale to name the persons behind the alleged fraud at the Social Health Authority (SHA).
Even as he applauded Duale’s ongoing crackdown on health facilities defrauding SHA, the Senate Majority Leader still urged Duale to take the bolder step in revealing who is behind the fraud so that they could face the full force of the law.
On Monday, August 25, Duale exposed massive fraud at SHA, with investigations uncovering disturbing trends, including upcoding, falsification of medical records, converting outpatient visits into inpatient admissions, and phantom billing for non-existent patients.
“Hon Aden Duale. Keep your eyes on the prize. Universal Health Coverage (UHC) must be attained. Do not be intimidated by the corrupt media peddling falsehoods, sponsored by cartels who have gamed our health care system in public and private avenues to near collapse. This is a war you cannot afford to lose,” Cheruiyot noted on Monday.
“As you share the list of facilities trying to game the system, can the country also know the personnel aiding this?” he challenged.
While announcing an impending crackdown, Duale informed that claims worth Ksh10.6 billion had been rejected due to fraudulent activities or non-compliance.
He added that aside from the suspension of 40 facilities by SHA over fraudulent activities, the Ministry of Health would also degazette an additional 45, which had been flagged over their links to fraud.
This was in addition to the closure of 728 non-compliant facilities and the downgrading of 301 others by the Kenya Medical Practitioners and Dentists Council (KMPDC).
Hospitals On The Spot
Among the flagged hospitals were Nabuala Hospital in Bungoma, which was on the spot for falsified claims involving multiple Caesarean sections on the same patient. Also highlighted was Kotiende Medical Centre in Homa Bay, over fabricating documents with the same medic signing off for both day and night shifts.
In Nairobi, Vebeneza Medical Centre was flagged for converting outpatient visits into inpatient claims, while Jambo Jipya Hospital in Mtwapa was found to have submitted fraudulent Caesarean section claims for a normal delivery.
In Mandera, a group of facilities, including Al-Masry Nursing Home, Care Connect Hospital, and Zamzam Nursing Home, was accused of colluding to submit 312 fraudulent claims for patients allegedly admitted on the same dates across multiple hospitals.
Meanwhile, Duale has claimed that a well-orchestrated scheme by some groups, including the media, had been recruited to water down the government's efforts to reform the health sector.
Still, the CS pledged his commitment to spearhead reforms in the SHA, despite ongoing negative commentary from a section of Kenyans.
"No amount of propaganda or blackmail will deter us from fixing our healthcare system. We know saboteurs of SHA have recruited several groups, including some sections of the media, to advance their agenda," Duale wrote in a statement released on Monday.
"Let them be warned: We are fixing this thing regardless of the noise! Our work has just begun. We will not rest until every Kenyan has access to quality, affordable and dignified healthcare, free from the burden of fraud," he added.
