The government has unveiled a series of urgent reforms aimed at improving access to healthcare services for civil servants under the Public Officers Medical Scheme Fund (POMSF), following the signing of a Joint Communiqué chaired by Health Cabinet Secretary Aden Duale.
The agreement introduces immediate and medium-term interventions designed to address persistent access challenges, including the removal of the tariff locking mechanism within the Social Health Authority (SHA) system.
The move is expected to ease delays and restrictions that have hindered service delivery at healthcare facilities.
In a significant directive, all contracted health facilities have been barred from charging civil servants any out-of-pocket fees.
This aligns with existing contractual obligations and reinforces the government’s push toward a strict “walk-in, walk-out” policy, under which beneficiaries will receive treatment without co-payments.
At the same time, provisions enforcing strict tariff applications—previously outlined under Clause 10.2(c—have been temporarily suspended.
This suspension will remain in effect pending the outcome of nationwide tariff negotiations set to begin on April 28, targeting private and faith-based Level 3 to Level 6 hospitals.
The process is expected to conclude within four weeks and aims to establish a harmonised, evidence-based reimbursement framework.
To respond to urgent complaints, a Joint Rapid Response Desk will be established immediately. The desk will bring together SHA, the State Department for Public Service, and the Union of Kenya Civil Servants (UKCS) to coordinate swift interventions.
Its mandate includes securing the release of civil servants detained in hospitals over unpaid bills and reviewing cases of unauthorized charges to facilitate refunds.
Speaking at the meeting, stakeholders emphasized accountability and system sustainability. SHA will enhance oversight through routine claims audits, utilisation reviews, fraud detection systems, and continuous monitoring of facility performance. Facilities found to be in breach of contractual terms—including charging beneficiaries—face sanctions such as de-contracting.
Additionally, SHA will maintain and regularly update a public list of approved healthcare providers to guide beneficiaries on where they can access services under the scheme.
The communiqué also highlights the need for improved communication with civil servants, particularly regarding system changes such as facility de-paneling.
Plans are underway to expand regional sensitisation forums, strengthen stakeholder engagement, and update the POMSF manual to make it more accessible and user-friendly.
The high-level meeting was attended by Principal Secretary for Medical Services Dr Ouma Oluga, UKCS Secretary General Lawrence Nyaguti, SHA Chief Executive Officer Dr Mercy Mwangangi, and Digital Health Agency CEO Eng. Anthony Lenayara, alongside senior officials from the Ministry of Health and the civil servants’ union.
The reforms signal a renewed effort by the government to streamline healthcare access for public officers while tightening oversight of service providers within the national health system.
