Six medics, private hospital charged over Ksh.2M false medical claims

Six medical staff and a private health facility in Mtwapa, Kilifi County, have been charged with conspiring to defraud the Social Health Authority (SHA) of more than Ksh.2 million through falsified medical claims.

Patrick Kimuyu Kanya, Faith Chepkirui Bil, Steven Okinyi Ojwang, Justine Baraka, Pauline Wanjiru, Naida Mbevu, and Jambo Jipya Medical Clinic face multiple counts, including conspiracy to commit a felony, forgery, and uttering false documents.

They all denied the charges and were on Monday released on bond.

The first and second accused were granted a bond of Ksh.600,000 or an alternative cash bail of Ksh.200,000, each with one contact person.

The third to sixth accused were released on a bond of Ksh.200,000 or a cash bail of Ksh.70,000, each with one surety. The case will be mentioned on October 21.

Before taking a plea, the defense sought to have some charges dismissed on the grounds that the court lacked jurisdiction, but the magistrate ruled that the court was properly seized of the matter.

According to the charge sheet, between November 1, 2024, and June 30, 2025, the accused allegedly conspired to alter and falsify medical information, resulting in fraudulent claims amounting to Ksh.2,032,680 being paid out by SHA.

In one instance, Patrick Kanya and Faith Chepkirui are alleged to have caused SHA to pay Ksh.30,000 by falsely claiming that a patient, Mary Njeri Njoroge, had undergone a caesarean section at the facility, while she had in fact delivered normally.

Other accused persons are linked to forged clinical notes and inpatient records for patients identified as Agnes Chisinde and Lucas Mwamba.

Prosecutors submit that the falsified documents were submitted to the SHA chief executive officer as genuine medical records to facilitate payment.

Specifically, Steven Ojwang and Justine Baraka are accused of forging clinical notes for Chisinde and Mwamba, while Pauline Wanjiru allegedly falsified a cardex in one of the inpatient files.

Naida Mbevu is accused of uttering the forged claim forms for both patients to SHA.