Health Cabinet Secretary Aden Duale/FILEThe government has warned hospitals against charging civil servants unauthorised fees as it moves to fully implement a new Public Officers Medical Scheme Fund (POMSF) tariff framework aimed at standardising healthcare costs across contracted facilities.
Health Cabinet Secretary Aden Duale said any facility found demanding illegal co-payments from public officers will face immediate sanctions, including suspension and forced refunds, under an enforcement system now backed by locked tariffs agreed with hospitals nationwide.
Duale said the government has concluded negotiations with private and faith-based health facilities and has formally locked the POMSF tariff structure into the Social Health Authority (SHA) system, marking a key shift in the management of civil servants’ healthcare benefits.
“We have successfully engaged healthcare providers, negotiated fair and sustainable tariffs, signed contracts, and are now officially locking these agreed tariffs into the system for full implementation,” he said.
The CS said the reforms follow widespread complaints from public officers over hospital detentions, delayed approvals and unauthorised payments during the transition to the new health financing framework.
He said the government’s intervention is aimed at restoring order and protecting beneficiaries from exploitation in hospitals.
“I made a firm commitment that no civil servant would be detained in a hospital or forced to make unlawful payments to access medical care,” Duale said.
The POMSF scheme, established under Legal Notice No. 195 of 2024, was created to ensure continuity of coverage for public officers while expanding their benefit package under SHA.
Duale said the enhanced scheme now covers outpatient and inpatient care, advanced surgical services, oncology, renal dialysis, dental and optical services, reproductive health services including In Vitro Fertilisation (IVF), and selected overseas treatment where necessary.
He said the government expects full compliance from contracted providers, citing the expanded coverage and a zero-tolerance stance on unauthorised billing practices.
“With the tariffs now locked, the era of uncontrolled co-payments is officially over. Walk in. Receive care. Walk out,” he said.
Under the new framework, hospitals will be required to strictly adhere to approved reimbursement rates, pre-authorisation rules and clinical guidelines, with SHA empowered to enforce compliance.
Duale said any deviation from the agreed terms will attract punitive action, including suspension from the scheme and mandatory refunds to affected patients.
He added that the government has received commitment from healthcare providers who participated in the negotiations, commending them for supporting reforms aimed at stabilising the public health financing system.
“We have successfully engaged healthcare providers who came to the table, negotiated in good faith and signed these tariffs. Your commitment ensures uninterrupted services for our public officers,” he said.
Duale said the reforms are part of a broader effort to ensure affordability, reliability and sustainability in Kenya’s health financing system while safeguarding the dignity of public servants seeking treatment.
He said the government will continue monitoring implementation closely to ensure compliance and prevent a return to informal billing practices that had undermined trust in the system.
