The Ministry of Health has ordered fresh investigations into Sisto Mazzoldi Hospital following allegations of fraudulent insurance claims submitted to the Social Health Authority (SHA).
In a statement issued on Wednesday, December 17, Health Cabinet Secretary Aden Duale directed the Kenya Medical Practitioners and Dentists Council (KMPDC) to immediately launch an in-depth investigation into new claims raised against the facility.
“The council is mandated to take the most stringent disciplinary actions available under the Medical Practitioners and Dentists rules should any malpractice be confirmed,” Duale stated.
In the statement, the Ministry also confirmed that Sisto Mazzoldi Hospital was already under active investigation by the SHA for allegedly submitting inaccurate and fraudulent claims.
Pending the outcome of the inquiry, the Ministry said the hospital had been suspended from offering services under the insurance scheme.
“In light of recent concerns raised regarding the nature of service delivery and claims submitted to SHA by Sisto Mazzoldi Hospital, the ministry wishes to clarify the ongoing actions taken to safeguard public interest and resources,” the statement read.
As part of the regulatory action, the cs revealed that KMPDC had already downgraded the facility from a Level 4 hospital to a Level 3.
The decision, Duale said, followed a comprehensive audit by KMPDC. The audit assessed the hospital’s human resource capacity, infrastructure, and scope of services.
The directive for fresh investigations follows an investigative report by NTV, which alleged that the hospital was involved in a scheme where staff members’ insurance details were used to claim funds from the government fraudulently.
According to the report, the proceeds were then allegedly shared equally between the hospital and the staff involved.
To curb the fraud under sha, the health ministry and the SHA executed a crackdown on healthcare fraud and non-compliance. In 2025, a move resulted in the suspension and closure of hundreds of hospitals.
As of late 2025, 85 hospitals had already been suspended from the SHA programme due to fraudulent billing.
The Ministry also reaffirmed its commitment to protecting patient safety, ensuring accountability, and safeguarding public funds.
It added that decisive action would be taken against any institution found to have undermined the integrity of the social health insurance system as the country pursues universal health coverage.
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