Duale defends SHA’s rejection of Sh10.8bn in claims citing fraud
Duale said an additional Sh3 billion in claims is under re-evaluation because of missing documents, while Sh2.1 billion remains under surveillance pending further investigation. - Kenya breaking news | Kenya news today | Capitalfm.co.ke..
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Health Cabinet Secretary Aden Duale has defended the Social Health Authority's (SHA) rejection of Sh10.6 billion in medical claims due to widespread fraud. This action is part of the government's intensified crackdown on healthcare fraud, with an additional Sh3 billion under re-evaluation and Sh2.1 billion under surveillance.
- The SHA has paid Sh53 billion and approved Sh6.4 billion in claims out of Sh82.7 billion submitted.
- The TaifaCare digital claims system, rolled out in October 2024, has detected irregularities like upcoding and phantom billing, leading to the shutdown of 728 non-compliant health facilities.
- Fraudulent providers will face prosecution and permanent removal from the SHA system, with the ministry recovering wrongfully paid funds.
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Health Ministry Rejects Sh10.6Bn in Fraudulent Claims and Hires 7,414 UHC Staff - August 2025
Health Cabinet Secretary Aden Duale defended the Social Health Authority's (SHA) rejection of Sh10.6 billion in medical claims, citing widespread fraud. The Ministry of Health revealed a significant fraud scheme within SHA, which has led to numerous facility closures. An additional Sh3 billion in claims is under re-evaluation, and Sh2.1 billion is under surveillance as part of the government's intensified crackdown on healthcare fraud. In a separate development, the Ministry of Health announced the permanent absorption of 7,414 temporary Universal Health Coverage (UHC) staff. These employees will be transitioned to permanent and pensionable terms by September 2025 following a verification process.
