Five individuals, including senior officials from a private health facility in Oyugis and staff members of the Social Health Authority (SHA), have been charged in court over an alleged scheme to defraud the Authority of more than Ksh. 17.5 million through falsified medical claims.
The accused Arthur Otula, Rosemary Daraja, Peter Abuna, Robert Ingasira, and Archprime Medical Clinic Oyugis Ltd appeared before a Nairobi court where they denied ten charges related to conspiracy to defraud, falsification of health information, acquisition and use of proceeds of crime, uttering false documents, and misappropriation of funds.
According to the prosecution, the five, together with others not before the court, allegedly conspired between October 2024 and May 2025 to defraud SHA of Ksh. 17,591,473 by submitting fraudulent medical claims through Archprime Medical Clinic in Oyugis, Homa Bay County.
In the first count, all the accused were charged with conspiracy to defraud under Section 317 of the Penal Code. The second count accused Otula, Daraja, and Abuna of falsifying medical documents in violation of Section 48(1)(c) of the Social Health Insurance Act, with the intent to unlawfully claim benefits.
The third and fourth counts alleged that Otula, Daraja, and Archprime Medical Clinic unlawfully acquired and used proceeds of crime contrary to the Proceeds of Crime and Anti-Money Laundering Act, by obtaining and spending over Ksh. 17 million in fraudulent SHA disbursements.
Daraja, who worked at Archprime Medical Clinic, faced an additional five counts of uttering false documents under Sections 353 and 349 of the Penal Code. She is accused of submitting falsified medical records for several patients including Edna Amondi Dulo, Maureen Atieno, Alice Akinyi Oburu, Felix Omondi Omondi, and Andrew Okaka to SHA while claiming they were genuine.
In the final count, SHA officials Elijah Wachira and Robert Ingasira were charged with misappropriation of funds contrary to Section 48(2) of the Social Health Insurance Act, for allegedly mishandling the Ksh. 17.5 million belonging to the Authority.
All the accused pleaded not guilty and were each released on a cash bail of Ksh. 500,000 pending trial.
