Wamuzi News Ke
In a sharply worded advisory, the government, through the Social Health Authority (SHA), has urged all Kenyans to vigilantly review their hospital bills and service records—amid mounting reports of fraudulent billing and inflated claims under the national health scheme.
The alert comes at a critical moment for SHA, whose legitimacy and finances are being tested by allegations of abuse and ghost facility claims worth billions.
SHA CEO: Verify Immediately, Report Discrepancies.
In a public statement issued Wednesday, SHA CEO Mercy Mwangangi cautioned that patients must ensure their hospital visits are correctly captured in the SHA system on the exact date services were rendered. Upon validation, patients receive a confirmation message sent to their registered number—listing visit details for verification.
Mwangangi emphasized that this cross-check must precede leaving the health facility, and urged Kenyans to compare billed services with those actually received. She warned that providers attempting to slip in extra charges, double entries or phantom items would face strong action.
SHA has provided a toll-free helpline (147) and mechanisms for patients to lodge complaints if discrepancies are found—either through the facility itself or directly with SHA.
Fraud Allegations: From Ghost Hospitals to Bill Padding.
The advisory follows revelations that rogue hospitals and individuals have sought to exploit SHA’s rollout. Investigations show attempts to siphon over KSh 10.6 billion through manipulated claims—ghost hospitals, fabricated patient encounters, and inflated billing.
One prominent case involved SHA wiring KSh 20 million to a “ghost hospital” situated in a forested area with no known health facility on record. In response, SHA has already suspended 40 health facilities suspected of irregular or fraudulent conduct, barring them from accessing benefits until compliance is restored.
Moreover, in September 2025, the Directorate of Criminal Investigations (DCI) received 1,188 files forwarded by SHA and the Kenya Medical Practitioners and Dentists Council (KMPDC) concerning suspected health fraud cases.
Why This Matters: Risking SHA’s Viability.
If unchecked, fraudulent claims could drain SHA’s coffers and jeopardize service delivery to genuine patients. Each illicit billing impacts sustainability, undercuts health access, and damages public trust.By warning the public to act as watchdogs, SHA appears to shift part of enforcement from internal audit to citizen vigilance—a risky strategy in an environment where many patients lack billing literacy.
