A suspect accused of orchestrating a fraudulent scheme that siphoned more than Sh11 million from Kenya’s public health insurance system has been arraigned in court as authorities intensify investigations into alleged abuse of medical claims.
According to the Directorate of Criminal Investigations (DCI), detectives from the agency’s headquarters presented Mishael Otieno Okumu before court on Monday, March 9, over claims he fraudulently obtained millions from the Social Health Authority (SHA).
Investigators say Okumu is the director of Salama Yard Medical Center Laboratory and Maternity Services, a health facility located in Nairobi’s Pipeline area.
The facility is accused of engaging in a series of irregular practices that enabled the submission and payment of fraudulent medical claims.
Preliminary investigations revealed suspicious admission patterns and questionable documentation linked to the facility.
Detectives also discovered the alleged use of expired or unauthorised practitioner credentials, falsified patient records, and fake patient admissions that were later used to bill SHA for services that were either exaggerated or never provided.
Authorities say the irregularities allowed the facility to successfully submit claims amounting to over Sh11 million, raising red flags within the health authority’s monitoring systems.
Following the investigations, Okumu and the facility were slapped with seven criminal charges.
The charges include obtaining registration by false pretence contrary to Section 320 of the Penal Code, making false statements, and falsification of documents contrary to Section 48 (1) (c) of the SHA Act.
The suspect also faces charges related to acquisition and use of proceeds of crime under the Proceeds of Crime and Anti-Money Laundering Act (POCAMLA).
When the charges were read in court, Okumu pleaded not guilty.
The court ordered that he be remanded at Capitol Hill Police Station pending the preparation and presentation of a probation report.
Bail and bond terms are expected to be determined on March 16, 2026.
The DCI has reiterated its commitment to pursuing justice in the ongoing investigations surrounding alleged fraud within the Social Health Authority system.
In a statement, the agency emphasised that it remains determined to protect public resources and hold all culpable individuals accountable, noting that investigations into the matter are still ongoing and more suspects could be brought before the courts as inquiries continue.
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