NAIROBI, Kenya — Detectives from the Directorate of Criminal Investigations (DCI) have arraigned a Nairobi clinic director accused of fraudulently claiming more than Sh11 million from the Social Health Authority (SHA).
The suspect, Mishael Otieno Okumu, appeared in court on Monday after investigators linked him to alleged fraudulent medical claims submitted through a health facility operating in the Pipeline area of Nairobi.
According to the DCI, investigations established that Okumu is the director of Salama Yard Medical Center Laboratory and Maternity Services, a facility allegedly involved in irregular practices designed to secure unlawful payments from the national health scheme.
Fraudulent Medical Claims
Detectives said the facility engaged in several suspicious activities, including false patient admissions, irregular admission patterns, use of expired or unauthorised practitioner credentials, and fraudulent billing.
The alleged practices enabled the submission of claims that cumulatively amounted to more than Sh11 million from the health insurance programme.
Investigators said the fraudulent activities violated multiple provisions of Kenyan law governing public health insurance and financial crimes.
Multiple Criminal Charges
Okumu and the facility face seven criminal counts, including obtaining registration by false pretence under Section 320 of the Penal Code.
He was also charged with making false statements and falsifying documents contrary to Section 48(1)(c) of the Social Health Authority Act.
Additional charges relate to financial crimes under the Proceeds of Crime and Anti-Money Laundering Act (POCAMLA), including the acquisition of proceeds of crime and the use of proceeds of crime.
Prosecutors allege that the suspect unlawfully benefited from the fraudulent payments obtained through the alleged scheme.
Court Proceedings
Okumu pleaded not guilty to all charges when he appeared before the court.
The court ordered that he be remanded at Capitol Hill Police Station pending the preparation of a probation report that will guide the determination of his bail and bond terms.
The court is expected to issue the bail ruling on March 16, 2026.
Wider SHA Investigations
The DCI said the case forms part of broader investigations into suspected fraud targeting the Social Health Authority, Kenya’s public health insurance system that replaced the former NHIF framework.
Authorities have intensified scrutiny of medical facilities suspected of inflating claims, falsifying patient records, or manipulating billing systems to siphon public funds.
“The Directorate of Criminal Investigations remains unwavering in its pursuit of justice in the Social Health Authority fraud investigations,” the agency said in a statement.
Investigators added that additional suspects may be charged as the probe continues.
Officials say the crackdown is intended to safeguard public health funds and restore confidence in the national health insurance system, which serves millions of Kenyans.
