The Ministry of Health Kenya, Social Health Authority (SHA), and the Union of Kenya Civil Servants have struck a joint agreement to address ongoing challenges affecting healthcare services for public officers under the Public Officers Medical Scheme Fund (POMSF).
In a joint statement issued on Thursday, the three institutions said the deal followed consultations aimed at resolving recent disruptions faced by civil servants while seeking treatment. These issues included reports of patients being detained in hospitals and cases of unauthorized co-payments.
The parties reaffirmed their commitment to protecting the welfare and dignity of civil servants, emphasizing that medical benefits under the scheme have not been reduced. They noted that outpatient cover, exceeding Ksh. 70,000, depending on job groups, remains unchanged. Beneficiaries will also continue to enjoy comprehensive optical and dental services, covering over 120,000 principal members and their dependents.
As part of immediate reforms, SHA has directed all contracted healthcare facilities to stop charging civil servants any additional out-of-pocket fees. The directive reinforces existing contractual agreements between providers and the authority, with strict adherence expected. Additionally, tariff applications under the scheme’s addendum will remain suspended.
To help beneficiaries easily access services, SHA will publish a full list of all contracted healthcare facilities on its official platform. This move is expected to improve transparency and guide civil servants on where to seek care.
Measures to Sustain the Fund
The authority also outlined steps to ensure the long-term sustainability of the fund. These include:
- Routine claims audits to detect fraud
- Quarterly reviews of service utilization
- Continuous monitoring of financial performance
SHA further stated that it will streamline its provider network by working only with facilities that meet clinical standards and adhere to agreed pricing structures. The agreement signals a renewed effort by the government and key stakeholders to stabilize healthcare access for civil servants while maintaining accountability and efficiency within the scheme.
