SHA Fraud Scandal: Clinic Owner Charged with Billing for Services Not Contracted
"The accused person is a father of three, and his place of abode is known. I want to notify the court that the accused has health complications and needs to be considered," the lawyer submitted.
Josephat Ouma Omoto was charged before the Milimani Chief Magistrate, Dolphina Alego, with misappropriation of funds under the Social Health Insurance Act by inducing the Social Health Authority (SHA) to pay a claim of Ksh 2,591,125 to Zion Ahadi Mediclinic Limited, which was not contracted to offer inpatient and maternity services. The offence took place on diverse dates between January 1 and June 30, 2025.
In the second count, the prosecution informed the court that the accused falsified information in the medical documents by inserting patients’ details to misrepresent that the patients had undergone treatment within the facility.
The court heard that he intended to defraud SHA by obtaining benefits not lawfully due under the insurance Act.
During the aforementioned period within Kakamega County, he acquired and used the said money, which formed part of the proceeds of crime contrary to Section 4 (a) as read with Section 16 (1) of POCAMLA.
Omoto, also charged with uttering a false discharge summary in inpatient files for Florence Rachael Atero claim number 2262927, Milka Omwaka Winnie claim number 1506677, and Elida Omunyokho Omukoyia claim number 226927, to the CEO of the SHA, purporting it to be a genuine document.
The offence took place on diverse dates between March 11 and 16, 2025, at Zion Ahadi Mediclinic Limited.
He denied the charges and, through his lawyer, pleaded for lenient bond terms, citing that he is not a flight risk.
“The accused person is a father of three, and his place of abode is known. I want to notify the court that the accused has health complications and needs to be considered,” the lawyer submitted.
The prosecution opposed the application by the defence, citing that no medical report was provided before the court to prove the issue of his health.
Though they did not oppose his release on bond, they urged the court for the terms commensurate to the offence, noting that the matter had drawn public interest.
In her directions, the Magistrate requested a pre-bail report before granting bond terms on Monday, January 12, 2026.
