Private clinic owner charged after obtaining Ksh.2.5M in SHA fraud

A proprietor of a private medical facility in Kakamega County has been arraigned before the Milimani Law Courts facing multiple charges related to the alleged falsification of health documents and laundering of proceeds obtained from the Social Health Authority (SHA).

Josephat Ouma Omoto, the proprietor of Zion Ahadi Mediclinic Limited, was charged with falsification of health documents contrary to Section 48(3) of the Social Health Insurance Act.

Prosecutors allege that between 1st January 2025 and 30th June 2025, Omoto knowingly and fraudulently falsified medical records by inserting patient details to misrepresent that patients had consented to or undergone treatment, with the intention of defrauding the Social Health Authority and unlawfully obtaining benefits.

In Count III, Omoto and Zion Ahadi Mediclinic Limited jointly face charges of acquiring proceeds of crime contrary to Section 4(a) as read with Section 16(1) of the Proceeds of Crime and Anti-Money Laundering Act (POCAMLA).

The prosecution alleges that during the same period, the accused acquired Ksh.2,591,125 from SHA through a Cooperative Bank account, knowing or having reasonable grounds to believe that the funds were proceeds of crime.

In a related charge, Omoto is accused of using proceeds of crime, contrary to Section 4(b) as read with Section 16(1) of POCAMLA. It is alleged that he knowingly used the said funds while aware, or reasonably expected to be aware, that they originated from criminal activity.

The accused further faces three separate counts of uttering false documents contrary to Section 353 of the Penal Code. The prosecution claims that Omoto fraudulently submitted false inpatient discharge summaries to the Chief Executive Officer of the Social Health Authority for purposes of claims processing.

Count V relates to a discharge summary for Florence Rachael Atero (Claim No. 4745787), allegedly uttered between 11th and 16th March 2025.

Count VI concerns a discharge summary for Elida Munyokho Omukoyia (Claim No. 2262927), allegedly submitted between 11th and 21st January 2025.

Count VII involves a discharge summary for Milka Omwaka Winnie (Claim No. 1506677), allegedly uttered between 2nd and 5th January 2025.

All the alleged offences are said to have occurred at Zion Ahadi Mediclinic Limited within Kakamega County.

Omoto, described in court as a father of three and a diabetic, was presented before the court as police sought custodial orders. The court directed that a pre-bail report be prepared and availed on Monday, pending further directions on bond and bail.

The matter will be mentioned for further proceedings once the pre-bail report is filed.