The Social Health Authority (SHA) has suspended Bungoma West Hospital for ninety (90) days over suspected fraudulent claims.
In a notice dated March 30, 2026, SHA CEO Mercy Mwangangi said that preliminary investigations had uncovered possible breaches of contractual obligations on corrupt and fraudulent practices.
The authority cited suspected submission of fictitious claims, including billing for services not rendered.
“Following reports of suspected fraudulent claims practices at Bungoma West Hospital. including [e.g., “submitting claims for unperformed services”], from our preliminary investigations, SHA has identified breaches of GCC Clause 16 (Corrupt and Fraudulent Practices),” read part of the statement.
SHA Bars Bungoma West Hospital from Serving Beneficiaries for 90 Days
The suspension, which took effect immediately, barred the hospital from admitting SHA beneficiaries, processing notifications, seeking pre-authorizations, submitting claims, or receiving payments during the period under review.
Additionally, SHA CEO Mercy Mwangangi stated that the Authority will not bear responsibility for any services provided to beneficiaries without prior approval during the suspension period.
The hospital was directed to transfer all current SHA patients to the nearest contracted facilities in coordination with the SHA branch office in Bungoma.
The hospital was mandated to notify affected beneficiaries of the suspension and cooperate fully with ongoing investigations.
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Bungoma West Hospital Suspends SHA Services, Shifts to Cash Payments
The clarification came after a letter from Bungoma West Hospital announcing the suspension of its services circulated online, with Kenyans alleging the move was due to delayed payments by the Social Health Authority.
In the April 3 letter, the hospital directed affected patients to seek care at alternative accredited facilities.
Additionally, it stated that the decision took effect at 12 noon due to unresolved issues with the insurer.
The facility advised SHA beneficiaries to seek treatment from other SHA-contracted hospitals within the region.
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The hospital, however, assured that critically ill patients currently under its care would continue receiving treatment, with management working on measures to ensure there is no disruption.
Going forward, the facility stated that all services would be offered strictly on a cash basis, with non-SHA clients and those under other insurance schemes continuing to receive services as usual.
Staff were directed to attend to all patients except SHA beneficiaries, unless they opt to pay in cash at the main hospital.
The management expressed regret for the inconvenience caused and appealed for clients’ understanding and cooperation.
