RUPHA_Kenya

The rejection of Kshs 11B in so called "suspicious claims" has had unprecedented disastrous effects on the health system. It is nothing to celebrate and trumpet. It is a failure on your part. It hurts Kenyan patients as hospitals now are super selective on the patients they take on. Practice 360 has made the management of cancer cases a nightmare, we have limited oncologists and radiotherapists in Kenya, expecting them to make a request from the precincts of hospitals is unreasonable. Denying facilities avenues for redress on rejected claims is a flagrant violation of your own SHA regulations, contract and natural justice.

Dear Ode Francis, @citizentvkenya ​Thank you for reaching out and for Citizen TV's continued role in keeping the public informed. The Ministry of Health and the Social Health Authority (SHA) take matters of fraud with the utmost seriousness. Regarding the recent impersonation incident at Mbagathi Hospital, please find the Ministry’s official responses below: ​ 1. Measures against SHA beneficiaries involved in fraudulent activities Any beneficiary found colluding to defraud the Authority faces severe legal consequences. Under Section 48(1) (c) of the Social Health Insurance Act, 2023, fraudulently altering or providing false information is a criminal offense. Beneficiaries involved in such schemes are immediately handed over to the Directorate of Criminal Investigations (DCI) for prosecution. Charges can include conspiracy to defraud under the Penal Code and, where applicable, asset recovery under the Proceeds of Crime and Anti-Money Laundering Act (POCAMLA). We are ensuring that the full force of the law is applied to both the healthcare providers and the beneficiaries facilitating these crimes. ​ 2. Estimated financial loss due to fraud What is key is that our new digital health system has become crucial in detecting and preventing fraud before funds are lost. Because of these robust digital safeguards, the system recently flagged and rejected suspicious claims worth approximately KSh 11 billion. This demonstrates that our digital infrastructure is working exactly as intended to protect public health resources. 3. Ministry steps to prevent future cases of fraud The impersonation incident at Mbagathi Hospital highlights the vulnerabilities of older verification methods. To permanently curb this, the Ministry has implemented the following measures: ​Biometric Health Identification (BHI): We have phased out the easily compromised One-Time Password (OTP) system. Patient identification across Level 4, 5, and 6 facilities now requires fingerprint authentication to ensure the person receiving care is the actual registered beneficiary. Rollout to Level 2 and 3 facilities is currently underway. Practice360 App: Healthcare professionals must now use this geo-fenced application for pre-authorizations, preventing unauthorized off-site approvals and code-sharing. ​ AI-Driven Fraud Detection: SHA has deployed an advanced AI system that flags anomalous billing patterns (such as upcoding or irregular admissions) in real-time, instantly blocking suspicious claims for manual forensic review. ​Facility Suspensions & Prosecution: We have actively suspended dozens of non-compliant facilities and withdrawn SHA platform access rights from implicated medical personnel, turning their files over to the DCI. ​The Ministry remains committed to protecting public health funds and ensuring that every shilling serves its intended purpose of providing quality healthcare to Kenyans.

KSH 11 Billion! That number is no pocket change. That money could equip hospitals with lifesaving machines and medicine, and hire and pay thousands of healthcare workers for years. I believe in @_shakenya. I believe in Universal Healthcare. However, it is painful when citizens’ salaries are deducted to support social health programs, yet Kenyans still suffer due to mismanagement, system weaknesses, and corruption risks. Whether paid out or intercepted, the fraudulent attempt itself exposes serious loopholes that must be urgently sealed. I am calling on the CS for Health, @HonAdenDuale, to release full SHA payment data. From ghost patients to fake hospitals, we must expose leakages, flag fraud, and ensure public funds are protected. Our healthcare system is in critical condition. It needs urgent CPR. That CPR is transparency and accountability. I support the good the government is doing, but I will equally call out the failures. Accountability is not opposition, it is leadership. As leaders, we must work for Kenyans and protect the trust they have placed in us above all else. SHA must work. And it will only work if trust, transparency, and consequences go hand in hand.

@HonAdenDuale Waziri you have our full support to go against fraud in the health sector. We would like to see accountability for public resources so that excellent hardworking hospitals can get paid on time, instead of loss of revenue through a few unscrupulous SHA_preneurs. We also would like to see clinical review of claims fast tracked (build capacity here Waziri), we have a 6 months review backlog, this is straining cashflow. We know you can do it! @_shakenya @MOH_Kenya @StateHouseKenya

@HonAdenDuale @_shakenya How nice would it be to also conclude funding to hospitals? How nice to conclude the payments to ghost hospitals. How nice to conclude the ambulance launch. How to conclude the Disputes Resolutions Tribunal. How nice to conclude.

As I concluded my health tour of Bomet County, I officially launched the state-of-the-art 160-slice CT scan centre at Longisa County Referral Hospital, significantly strengthening diagnostic imaging capacity for the county and the wider region. The facility enables advanced imaging for neurology, oncology, trauma and comprehensive full-body assessments, improving emergency response, reducing referrals and bringing specialised services including chemotherapy support closer to residents. To further accelerate health system digitisation, I also handed over 831 digital devices, adding to the 32,000 devices already deployed nationwide to support efficient and data-driven service delivery. Addressing the public, I urged County leadership to ensure Primary Health Care (PHC) services, fully funded by the Government, remain free, in line with the directive of H.E. President William Ruto. I further commended Community Health Promoters for their unwavering commitment to bridging healthcare access and promoting wellness at the grassroots level.

@_shakenya you are collapsing the healthcare sector The price we are paying is rising Maternal Mortality, Closed Hospitals and skyrocketing out of pocket payments for Kenyans. Everyone else is corrupt BUT YOU. @HonAdenDuale you are listening to the wrong people.

In a groundbreaking event, Liaison Group and @RuphaKenya announced a strategic partnership to transform private healthcare and strengthen Kenya’s UHC agenda. RUPHA360 was officially launched at the Nairobi Serena Hotel. #ImpactforGood #RUPHA360Launch Read More about the Launch: bit.ly/4oz1ekc

Money owed to the defunct NHIF by various Ministries, Departments and Agencies as at 30th September 2024. It is instructive to note that the @MOH_Kenya owes the lion share at Kshs 7.8B followed by the Ministry of Public Service (Civil Servants Medical Scheme) at Kshs 3.47B. So @HonAdenDuale when is your Ministry settling its 7.8B? This is enough for 91% of all hospitals in Kenya

Thank you @KenyaAirways for this great tribute to a Legend.

Good Morning. @HonAdenDuale Since you're our CS clarify. Items number 26 and 27 of the Safaricom Consortium (APEIRO, Konvergenz) contract with the Ministry of Health are (a) Data Bundles of 30 Terabytes per month to support level 2-4 primary healthcare facilities. And (b) broadband internet for level 4-6 hospitals. Data bundles Kshs 1.35Billion and broadband Kshs.2.199B. Is your local health centre getting these data bundles for free from Safaricom? I hope you notice we are spending ksh 43B on Softwares.

We definitely support sports, rugby sevens is a special experience. BUT. There is a fund for sports. How does this fit into the 5% administrative costs cap that the @_shakenya has? Secondly, the rugby demographic is youthful urban, educated, probably employed (fingers crossed) anyone who attends rugby sevens knows this. Compare that with the soccer demographic or the bull fighting demographic or the Chamaz demographic. Those are the groups that desperately need the SHA gospel in our view. It's looking like someone's vanity project at a time when the fund can't pay basic bills.

Dear CS @HonAdenDuale RUPHA takes cognisance of the request that you have made today to @KeTreasury CS Treasury @JohnMbadiN to make available Kshs 5.3B to clear @_shakenya liabilities that it inherited from the NHIF. We cautiously welcome this development as a step in the right direction towards the partial settlement of the historical liabilities of the Social Health Authority. We thank you for acknowledging that unpaid medical claims have constrained the provision of healthcare services in Kenya and are a threat to the national dream of Universal Healthcare. We urge CS @JohnMbadiN to act expeditiously on your request as it's in line with the National Treasury's internal policy on retiring pending bills whose value is below Kshs 10M. As for claims that H.E the President @WilliamsRuto instructed verification for, RUPHA offers no objection to this. We only ask for the process to begin NOW. Hospitals request that you move with characteristic speed to establish team and initiate the verification mechanism in line with the guidance provided to you via the High Court in "Gikenyi B & 3 others v Committee & 23 others (Petition E011 of 2025) [2025] KEHC 5823 (KLR) (12 May 2025) (Ruling)."

Taifacare/Linda Jamii/SHIF did not replace Linda Mama. It replaced NHIF. That's the correct comparison. We were there we know. What we know is that you abolished Linda Mama which covered vulnerable women of all ages and replaced it with special IDs for Teenage Moms. That's not an improvement. That's a downgrade for vulnerable women.

Under the defunct NHIF, the Linda Mama programme offered a reimbursement as low as KSh 2,500, with little regard for the quality of care provided. During that period, Kenya witnessed a worrying rise in maternal mortality rates as expectant mothers struggled to access comprehensive services. With the introduction of Taifa Care, we have shifted the focus to the dignity and wellbeing of every mother and child. The programme guarantees quality prenatal, delivery and postnatal care, ensuring that mothers are supported at every stage of their journey.

One year of SHA. Tomorrow morning on @citizentvkenya with our Chairman @BrianLishenga

Make SHA actually work

@_shakenya @DHA_Kenya @MOH_Kenya @HonAdenDuale Kenyan patients need you to act right.

@RobertAlai Tough luck. How is your land grabbing case going?

These cartels needs to be arrested.

Our Chairman @BrianLishenga shares thoughts on the new indigent and vulnerable Kenyan scheme launched by H.E @WilliamsRuto today.