By Court News Staff Reporter
Six people, including the management of Archprime Medical Clinic in Oyugis, have been charged in a Nairobi court with conspiracy to defraud the Social Health Authority (SHA) of more than Sh17 million through false medical claims and misappropriation of public funds.
The accused — Arthur Otula, Rosemary Daraja, Peter Abuna, Elijah Wachira, Robert Ingasira, and the clinic itself — appeared before Milimani Chief Magistrate Lucas Onyina.
Fraudulent Claims Scheme
According to the prosecution, the six suspects conspired to defraud SHA of Sh17,591,473 between October 2024 and May 2025 at various locations in Kenya.
Court documents indicate that Otula, Daraja, and Abuna falsified information on medical claim forms and supporting documents with the intention of fraudulently obtaining payments from SHA under the Social Health Insurance Act.
The trio allegedly submitted fake treatment records and inflated invoices for non-existent medical services at Archprime Medical Clinic, located in Oyugis, Homa Bay County.
Forgery and Acquisition of Proceeds of Crime
The prosecution said the accused also acquired proceeds of crime by fraudulently obtaining Sh17,591,473 in public funds through falsified claims.
Rosemary Daraja faces additional counts of uttering false medical documents to the CEO of SHA, purporting them to be genuine medical records.
The charges highlight a complex fraud network allegedly involving false documentation, forged records, and systematic submission of fake claims to siphon millions from the national health fund.
Misappropriation by Officials
Two other accused persons, Elijah Wachira and Robert Ingasira, who were SHA officials, are charged with misappropriation of funds.
The court heard that between the same dates, while entrusted with management responsibilities at the SHA headquarters in Nairobi, the duo misappropriated Sh17,591,473, the property of the health fund.
Court Proceedings
Appearing before Chief Magistrate Lukas Onyina, Otula, Daraja, Abuna, and Ingasira denied all charges.
Wachira did not appear in court and was directed to take plea next week.
The court granted the four accused persons bond of Sh800,000 each, with an alternative cash bail of Sh500,000.
The prosecution indicated that investigations into the case are still ongoing and that additional suspects may be charged as evidence unfolds.
SHA Responds to Fraud Allegations
A senior SHA official, speaking on condition of anonymity, said the authority has intensified audits and claims verification processes to protect public resources.
He noted that fraudulent claims have been a major challenge since the rollout of the Social Health Insurance Fund (SHIF), warning that all cases will be prosecuted to the fullest extent of the law.