The Directorate of Criminal Investigations (DCI) has confirmed the arrest of five suspects in connection with a sweeping probe into suspected healthcare fraud. The investigation centers on 1,188 files submitted by the Social Health Authority (SHA) and the Kenya Medical Practitioners and Dentists Council (KMPDC), exposing individuals and institutions allegedly undermining government healthcare initiatives.
Court Proceedings Scheduled
According to a statement issued on Friday, October 3, 2025, the suspects will be arraigned in court on Monday, October 6, 2025. They face multiple charges under:
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The Penal Code
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The Proceeds of Crime and Anti-Money Laundering Act
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The Social Health Insurance Act
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The Anti-Corruption and Economic Crimes Act
The DCI further confirmed that more arrests are expected as the Office of the Director of Public Prosecutions (ODPP) has approved additional investigations.
Background of the Files
The case gained momentum in early September 2025, when Health Cabinet Secretary Aden Duale handed over 1,188 files to the DCI.
Duale said the files contained evidence against fraudulent healthcare facilities, professionals, and individuals who have allegedly engaged in corruption and non-compliance, threatening the credibility of Kenya’s healthcare reforms.
“These files contain detailed evidence to support prosecution,” CS Duale stated, emphasizing that the government would not tolerate sabotage of the Social Health Insurance (SHI) program.
Joint Forensic Audits and System Checks
The files were compiled after weeks of joint audits involving the SHA, KMPDC, and the Clinical Officers Council (COC).
The multi-agency team conducted forensic audits and digital system checks, which reportedly uncovered deeply troubling practices in the health sector, including:
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False claims by health facilities
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Improper billing systems
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Use of ghost patients to siphon funds
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Non-compliance with SHI requirements
DCI Response
The DCI has since formed a multi-agency task force to fast-track investigations and ensure swift prosecution of all culpable parties.
A senior DCI officer confirmed that the fraud investigations are a national priority, given their potential to derail Kenya’s progress toward universal healthcare.
“The integrity of our healthcare system depends on accountability. No one will be spared, whether individuals or institutions,” the officer noted.
Wider Implications
The scandal is being described as one of the largest healthcare fraud probes in Kenya’s history. It raises serious concerns about accountability within government programs and could set a major precedent for how corruption in the health sector is handled going forward.