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An audit of SHA’s systems covering October 2024 to April 2025 detected about KSh 11 billion in suspected fraudulent reimbursement claims submitted by health facilities. These alleged losses are linked to fraudulent billing practices, including: • Billing for services not provided • Inflating procedure costs • Converting outpatient services into more expensive inpatient claims • Reporting ghost patients or implausible medical statistics (e.g., 100 % caesarean rate) Not so long ago, When Health CS
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