MP Shah: We will cooperate with SHA billing probe

Social Health Authority suspends MP Shah Hospital from offering services under the insurance scheme on June 23, 2026. [Jenipher Wachie, Standard]

The M.P. Shah Hospital has said that it will cooperate with investigations by the Social Health Authority (SHA) after the healthcare provider was temporarily suspended from offering services under government-funded health insurance schemes over billing complaints.

The suspension, which took effect on June 23, 2026, was announced by SHA Chief Executive Officer Mercy Mwangangi and affects services provided under the Primary Healthcare Fund (PHCF), Social Health Insurance Fund (SHIF), Emergency, Chronic and Critical Illness Fund (ECCIF), and the Public Officers Medical Scheme Fund (POMSF).

The move comes amid an intensified government crackdown on fraud, overbilling and abuse of public health insurance funds as authorities seek to safeguard taxpayer resources and improve accountability in the healthcare sector.

In a statement issued on Wednesday, M.P. Shah Hospital confirmed that it had received the suspension notice and had already launched an internal review while cooperating fully with SHA investigators.

“M.P. Shah Hospital has received a notice from the Social Health Authority (SHA) temporarily suspending our contract for the provision of services to SHA/SHIF beneficiaries, pending an investigation into billing complaints,” the hospital said.

The hospital acknowledged concerns regarding patient billing and emphasized that patients should not be required to make payments for services that ought to be covered under their SHIF benefits.

“Every patient who comes through our doors deserves to receive the care they are entitled to without unnecessary financial burden. If any of our patients were required to make payments that should have been covered under their SHIF benefit, that falls short of the standard we hold ourselves to, and we are committed to investigating and correcting it,” the statement added.

SHA did not disclose the specific allegations under investigation but maintained that the suspension was necessary pending completion of the inquiry.

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However, the authority assured patients already admitted at the hospital before the suspension took effect that their treatment would continue uninterrupted until discharge.

“To ensure a seamless transition and continuity of care, our beneficiaries already admitted at the facility before the suspension date shall continue receiving care till completion of their current episode of care and discharge,” said Mwangangi.

Patients seeking new admissions, follow-up treatment or other medical services have been advised to seek care at alternative SHA-contracted healthcare facilities.

The authority further encouraged beneficiaries requiring assistance with referrals or continuity of care to contact SHA through its toll-free number 147.

M.P. Shah Hospital said measures had already been put in place to support affected patients during the suspension period.

“Current patients are being supported with safe transfers to other SHA-contracted facilities where needed, and our teams are on hand to assist any affected patients,” the hospital said.

The suspension comes against the backdrop of sweeping reforms within Kenya's healthcare financing system following the transition from the National Health Insurance Fund (NHIF) to SHA and SHIF.

In recent months, the government has stepped up efforts to tackle fraud within the health insurance ecosystem. In April, Health Cabinet Secretary Aden Duale announced the closure of several health facilities implicated in fraudulent SHA claims and warned that investigations would continue across the sector.

SHA has also introduced an Artificial Intelligence-powered monitoring system to detect suspicious claims, including phantom billing, unnecessary medical procedures and fraudulent registration of dependents.

According to the authority, the technology has already flagged billions of shillings in questionable claims.

Currently, more than 6,300 healthcare facilities are contracted under SHA to provide services to beneficiaries across the country.

SHA says its priority remains protecting patients while ensuring public healthcare funds are used transparently and for genuine medical care.