(15 January 2026 | Source: Zakon.kz)
The Social Health Insurance Fund (SHIF) will be placed under the authority of the Ministry of Finance following an audit that uncovered systemic violations in payments for medical services. The decision was made amid rising budget costs and the accumulation of significant fund resources that are not actually being used to provide medical care.
WHAT THE ANALYSIS OF SHIF'S ACTIVITIES SHOWED
An analysis of the activities of the Social Health Insurance Fund was conducted by the Ministry of Finance on the instructions of the Prime Minister Olzhas Bektenov dated 18 December 2025. The audit results were presented on 16 January 2026 by the Minister of Finance Madi Takiyev, reports Zakon.kz.
According to the data presented, despite the increase in spending on the compulsory social health insurance system to 2.4 trillion tenge in 2026 (compared to 1.4 trillion tenge in 2020) the fund's work efficiency has not improved.
At the same time, the accumulated investment income of the SHIF since 2020 has amounted to 588 billion tenge, of which 195.9 billion tenge — for 2025. A significant portion of the funds is accumulated in the fund's assets and is not directed towards providing medical services.
WHAT VIOLATIONS WERE FOUND IN THE MEDICAL SERVICES SYSTEM
An IT audit of information systems identified a number of systemic violations. These include the addition of fictitious patients, provision of inappropriate medical services, and abnormally high volumes of medical activity over short periods.
In particular, cases were identified where, with an assigned population of 1,000 people, only around 500 patients actually sought care, yet payment was made for the entire population. There were also records of medical services being provided to deceased citizens, as well as the write-off of medicines in quantities inconsistent with actual treatment durations.
SPECIFIC EXAMPLES PROVIDED BY THE MINISTRY OF FINANCE
It is reported that the Minister of Finance cited a number of specific cases. For example, in one private clinic, a doctor saw 1,442 patients in a single day, against an average standard of up to 24 consultations per day. In another instance, a doctor saw 4,832 patients in one month in Astana.
Specifically highlighted were 3,640 cases of medical services provided to 996 deceased patients, including an appointment booked in 2025 for a patient who died in 2023. Also identified were 769,446 screening cases that did not correspond to the patient's gender, amounting to 1.8 billion tenge, including examinations of men for diseases typically associated with women.
DOUBLE FUNDING AND INCOME CONTROL
The analysis revealed two common mechanisms of double funding. In the first case, private medical organisations received payment simultaneously through employer voluntary health insurance and from SHIF funds. In the second, the same patient was registered with two medical organisations on the same dates.
Furthermore, tax authorities conducted a desk audit of the heads of medical organisations. The results established that 1,465 directors in 2024–2025 acquired over 5,000 properties, and 912 people acquired 1,416 cars. Some directors of private clinics purchased between 52 and 124 properties and between 14 and 24 cars each over two years.
WHAT DECISIONS HAVE BEEN MADE
Following the review of the materials, Prime Minister Olzhas Bektenov instructed:
- to refer all identified materials to law enforcement agencies for procedural decisions;
- to transfer the Social Health Insurance Fund to the jurisdiction of the Ministry of Finance to control all financial flows;
- to ensure complete digitalisation of healthcare business processes based on the Ministry of Finance's systems;
- to revise the parameters of the SHIF investment strategy and stop unjustified funding.
Earlier, on 6 January, at a government meeting, Prime Minister Olzhas Bektenov pointed to the existence of cases of excessive funding and the use of vulnerable schemes in subsidising private schools and medical organisations. In this regard, the relevant ministries were instructed to prepare proposals within a week for revising existing subsidy mechanisms.