The Social Health Authority (SHA) has agreed to withdraw the tariff locking system affecting the Public Officers Medical Scheme Fund (POMSF), following a joint consultative meeting involving the Ministry of Health, SHA and the Union of Kenya Civil Servants (UKCS).

The decision was communicated in a joint communiqué issued on April 23, 2026, addressing operational challenges that have affected access to healthcare services for civil servants.

The meeting focused on reported cases of service disruptions, including detention of patients in health facilities and demands for out-of-pocket payments.

The parties confirmed that the government has not reduced medical benefits under the scheme. Coverage remains in place, including outpatient limits exceeding Ksh70,000 depending on job groups, as well as optical and dental services for more than 120,000 principal members and their dependents.

“The contractual limits which exceed Ksh 70,000 for outpatient care, depending on job groups, alongside comprehensive optical and dental limits—remain fully intact for the 120,014 principal members and their dependents,” read the SHA statement in part.

Withdrawal of tariff locking system

Under the resolutions, SHA will immediately deactivate the tariff locking feature in its system. During the transition period, health facilities contracted under POMSF are required not to charge civil servants any additional out-of-pocket fees.

The communiqué stated that existing contractual obligations under the Main Contract and its Addendum remain binding. It further noted that provisions under Clause 10.2(c) of the Addendum will remain suspended until ongoing nationwide consultations are concluded.

Facilities offering services under the scheme are expected to comply with agreed terms while the system adjustments are implemented.

Rapid response

A Joint Rapid Response Desk has been established, bringing together SHA, the State Department for Public Service, and UKCS. The desk is tasked with facilitating the release of any civil servants who may be detained in health facilities and processing refunds for any unauthorized payments.

The mechanism is expected to handle urgent cases arising from the disruptions while ensuring coordination between government agencies and healthcare providers.

The communiqué also outlines that all affected cases will be reviewed and addressed through structured administrative processes.

Tariff negotiations

Nationwide tariff negotiations are scheduled to begin on Tuesday, April 28, 2026. The discussions will involve private and faith-based health facilities classified under Levels 3 to 6. The objective is to develop a harmonised reimbursement structure based on evidence and cost assessments.

Once concluded, contracted facilities will be required to adhere to a “walk-in, walk-out” policy, which prohibits co-payments for insured civil servants. Non-compliance may result in enforcement action, including termination of contracts.

SHA has also directed members to seek services only from approved facilities listed under the POMSF network. The authority will publish and regularly update the list of contracted providers on its official platforms.