NAIROBI, Kenya, October 7, 2025 — A major fraud case involving the newly established Social Health Authority (SHA) has come to light, after seven individuals were arraigned before the Milimani Law Courts for allegedly siphoning over Sh7 million through falsified medical claims.
The accused — Markdhillion Mutsotso, Patrick Kanya, Faith Chepkurui, Steven Okinyi, Justine Baraka, Pauline Wanjiru, and Naida Mbeyu — face a string of serious criminal charges, including conspiracy to commit a felony, forgery, falsification of records, obtaining proceeds of crime, cheating, and uttering false documents.
According to court documents and investigations presented by the prosecution, the suspects are alleged to have conspired to manipulate the SHA system by submitting fake medical claims for services that were never rendered to patients. The fraudulent activities reportedly took place between October 2024 and June 2025, involving two health facilities — Jambo Jipya Medical Clinic in Mtwapa, Kilifi County, and St. Mark Orthodox Health Centre in Chavakali, Vihiga County.
How the Scheme Worked
Investigations by detectives revealed that Kanya, Chepkurui, Okinyi, Baraka, Wanjiru, and Mbeyu — all affiliated with Jambo Jipya Medical Clinic — falsified medical records to claim reimbursements from the Social Health Authority. The false submissions allegedly led to irregular payments amounting to Sh2,032,680 within just eight months.
The group allegedly used real patients’ details to create fake treatment records and inflated billing statements, which they then presented to SHA as legitimate claims. The payments were processed and deposited into accounts associated with the clinic.
In a separate but related fraud, Markdhillion Mutsotso, an employee of St. Mark Orthodox Health Centre in Vihiga County, is accused of orchestrating another scheme in which the health centre allegedly received Sh5,128,400 in fraudulent claims between October 2024 and June 2025.
Court Proceedings and Bail Terms
During the court session, Senior Principal Magistrate [Name withheld] granted varying bond terms depending on the alleged roles of the accused.
- Patrick Kanya and Faith Chepkurui, both directors of Jambo Jipya Medical Clinic, were each granted a bond of Sh600,000 with a surety of the same amount or an alternative cash bail of Sh200,000.
- Steven Okinyi, Justine Baraka, Pauline Wanjiru, and Naida Mbeyu were each granted a bond of Sh100,000 or cash bail of Sh70,000.
- Mutsotso, linked to the Vihiga fraud case, was also released on a bond of Sh100,000 or cash bail of Sh70,000.
The court further issued warrants of arrest against Fenley Ngairah, the director of St. Mark Orthodox Health Centre, and Sammy Otieno, who are still at large. Authorities are urging the two to surrender to the nearest police station to aid in ongoing investigations.
Social Health Authority Speaks Out
Officials from the Social Health Authority (SHA) condemned the fraudulent acts, noting that such schemes undermine the government’s effort to roll out universal health coverage (UHC) for all Kenyans. The SHA is a new body formed to replace the National Health Insurance Fund (NHIF), with a mandate to ensure accountability and efficiency in health insurance claims.
“This case demonstrates that we will not tolerate corruption or fraudulent claims. Every shilling meant for patients must be protected,” said a source at SHA familiar with the matter.
Next Court Mention
The case will be mentioned again on October 21, 2025, when the prosecution is expected to update the court on the progress of investigations and whether the missing suspects have been apprehended.
The Office of the Director of Public Prosecutions (ODPP) has vowed to pursue the case to its logical conclusion, warning that medical facilities engaging in fraudulent practices risk de-registration and criminal prosecution.
