Six Charged in Ksh17.5 Million Social Health Authority Fraud Case

By Andrew KariukiĀ 

Six individuals, including officials linked to Archprime Medical Clinic in Oyugis, have been charged at the Milimani Law Courts with conspiring to defraud the Social Health Authority (SHA) over Ksh17.5 million through falsified medical claims and misappropriation of public funds.

The accused; Arthur Otula, Rosemary Daraja, Peter Abuna, Elijah Wachira, Robert Ingasira and Archprime Medical Clinic Oyugis, appeared before the court on Thursday, 30,October, 2025, where they all denied the charges.

According to the charge sheet filed by the Office of the Director of Public Prosecutions (ODPP), the six are accused of conspiring between October 2024 and May 2025 to defraud the Social Health Authority of Ksh17,591,473 by submitting falsified medical documents purporting to represent genuine treatment records from Archprime Medical Clinic.

The court heard that Rosemary Daraja, one of the accused, is separately charged with uttering several false medical records belonging to patients — including Edna Amondi Dulo, Maureen Atieno, Alice Akinyi Oburu, Felix Omondi and Andrew Okaka, which were presented to the SHA CEO as legitimate claims.

Two other accused persons, Elijah Wachira and Robert Ingasira, are facing additional charges of misappropriating funds under the Social Health Insurance Act, 2023, after allegedly diverting Ksh17.5 million belonging to SHA for their personal benefit while serving in management roles at the authority’s Nairobi headquarters.

Investigators further allege that the accused used and benefited from proceeds of crime, contrary to provisions of the Proceeds of Crime and Anti-Money Laundering Act (POCAMLA).

The prosecution listed several witnesses, including SHA officials and investigators from the Directorate of Criminal Investigations (DCI), expected to testify on how the falsified claims were processed and paid.

All six accused were released on a cash bail of Ksh 500,000 each, pending the hearing and determination of the case.

The matter will be mentioned on a later date as investigations continue.