DCI takes over investigations into the 1,188 alleged SHA fraud case files

BY ERIC ABUGA

The Directorate of Criminal Investigations (DCI) has formally taken over inqury into the alleged fraud among 1,188 health facilities under the Social Health Authority (SHA).

In a statement issued Monday eveining and sighned by the National Police Service Head of Communication John Marete, DCI will be giving regular updates on the investigations.

Marete said the files under investigations pertain to individuals, entities and various parties suspected of engaging in health care fraud.

"A multi-agency team has ben constituted under the leadership of the DCI with a view of expeditiously reviewing the files. All those who have been involved in nay form of healthcare fraud will be arraigned regardless of their social status and political affilitions," Marete's statement reads in part.

Health Cabinet Secretary Adan Duale in a press briefing with the Police Inspector General Douglas Kanja and the Director of Criminal Investigations Amin Mohammed, revealed that the Ministry has an artificial intelligence powered fraud detection system, which tracks every TaifaCare transaction in real time to stop irregular claims before payment. 

"The 1,188 case files have undergone a forensic review and digital audit by the Ministry of Health," said Duale.

The CS said that already, 1,300 facilities have been shut down for schemes such as falsifying records, inflating claims, converting outpatient cases into inpatient and billing for services never rendered.

To protect public funds, the CS said they have established a joint multi-agency team comprising the Ministry of Health, DIC, Social Health Authority (SHA), Kenya Medical Practitioners and Dentists Council (KMPDC) and the Digital Health Authority (DHA). 

"No perpetrator, be it a facility, provider or patient, will escape accountability."

Other leaders who attending the meeting include; Principal Secretaries Dr Ouma Oluga (Medical Services), Ms. Mary Muthoni (Public Health and Professional Standards), , DIG Mr. Gilbert Masengeli, CEOs Dr Mercy Mwangangi (SHA), Dr David Kariuki (KMPDC) and Eng Anthony Lenaiyara (DHA) among other senior government officials.