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By Benadeta Mwaura - Reporter
Kenya, 31 October 2025 - A high-level fraud investigation has rocked the Social Health Authority (SHA) after nine suspects, including former acting CEO Robert Ingasira, were arrested and charged with conspiring to defraud the agency of KSh 17.5 million through falsified medical claims.
The Directorate of Criminal Investigations (DCI) confirmed that the arrests followed weeks of probe into fake hospital payment submissions allegedly made through SHA’s claims system. The syndicate reportedly altered beneficiary data and submitted invoices for medical services never rendered.
“The arrests follow weeks of investigations into alleged financial irregularities, including conspiracy to defraud, falsification of records and misuse of funds within the SHA framework,” Capital FM reported, quoting an official brief from investigators.
The fraud involved payment requests from Archprime Medical Clinic in Homa Bay County amounting to KSh 17,591,473, alongside smaller claims from Vebeneza Enterprise Medical Clinic in Nairobi (KSh 1.1 million) and Nyatoto Health Centre (KSh 315,840).
Court documents indicate that the accused face charges of conspiracy to defraud under Section 317 of the Penal Code, misappropriation of public funds under Section 48(2) of the Social Health Insurance Act, abuse of office, and proceeds of crime under POCAMLA.
“Criminals downloaded and doctored the payment list,” Ingasira previously said when questioned over similar flagged claims earlier this year.
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Investigators allege that the forged documents were uploaded to the SHA’s digital claims platform using internal access credentials. The scandal has raised concerns about loopholes in the newly merged health-fund systems, which combined NHIF, SHIF and other schemes into SHA earlier this year.
All nine suspects, including senior finance officers and clinic directors, pleaded not guilty before the Anti-Corruption Court and were each released on KSh 500,000 cash bail pending trial.
The arrests are the first major test for the fledgling Social Health Insurance Fund, which was launched to curb leakages in public healthcare spending. Kenya loses an estimated KSh 10 billion annually to health-sector fraud, according to the Ethics and Anti-Corruption Commission (EACC).
As the case proceeds, SHA’s credibility faces scrutiny at a time when millions of Kenyans are transitioning into the new universal healthcare framework.
Nine Arrested in KSh 17.5 Million SHA Fraud Probe
Former CEO Among Suspects
