By MKT Reporter
The government has announced sweeping measures to restore order and confidence in the delivery of healthcare services to civil servants under the Public Officers Medical Scheme Fund (POMSF), following mounting concerns over service disruptions and unlawful charges.
In a joint communiqué issued after a consultative meeting, the Ministry of Health Kenya, the Social Health Authority (SHA), and the Union of Kenya Civil Servants (UKCS) outlined a series of binding resolutions aimed at addressing operational challenges that have recently plagued the scheme.
The meeting comes in the wake of alarming reports that some civil servants had been detained in hospitals over unpaid bills, while others were subjected to unauthorized co-payments despite being covered under the scheme.
Leading the government delegation, Health Cabinet Secretary Aden Duale acknowledged the gravity of the situation, describing the incidents as unacceptable and contrary to the principles of universal and equitable healthcare access.
Among the key resolutions is a firm reassurance that the government has not reduced medical benefits for civil servants.
Officials confirmed that outpatient cover exceeding KSh70,000 depending on job group alongside comprehensive dental and optical benefits, remains fully intact for over 120,000 principal members and their dependents.
To immediately ease pressure at health facilities, SHA announced the withdrawal of the controversial “tariff locking” system, which had been blamed for delays and confusion in service provision.
During the interim period, all contracted facilities have been expressly prohibited from charging civil servants any out-of-pocket expenses.
“This directive is anchored in the existing contractual obligations between SHA and healthcare providers,” said SHA Chief Executive Officer Mercy Mwangangi, adding that strict compliance will be enforced to protect beneficiaries.
The communiqué further emphasized that enforcement of tariff provisions under existing contracts will remain suspended pending further review, signaling a shift toward a more flexible and responsive system.
In a move to enhance transparency and accessibility, SHA also committed to publishing a comprehensive list of all contracted POMSF facilities on its official platforms, enabling civil servants to make informed choices when seeking care.
At the same time, authorities underscored the need for fiscal discipline to safeguard the sustainability of the fund. Planned interventions include rigorous claims audits to detect fraud, quarterly utilization reviews, and continuous monitoring of loss ratios.
The agency will also streamline its provider network, retaining only facilities that meet clinical standards and adhere to agreed pricing structures.
Speaking on behalf of workers, UKCS Secretary General Lawrence Nyaguti Ochieng welcomed the resolutions, expressing cautious optimism that the measures would restore dignity and reliability in healthcare access for civil servants.
All parties reaffirmed their commitment to protecting the health and welfare of public officers, emphasizing that efficient healthcare delivery remains a cornerstone of a productive public service.