SHA Announces Nationwide Negotiations To Reform Civil Servants’ Medical Cover

The Social Health Authority (SHA) is set to launch a series of nationwide negotiations with healthcare providers starting Tuesday, April 28, 2026. The move is aimed at finalizing fresh agreements under the Public Officers Medical Scheme Fund (POMSF) and resolving persistent operational hurdles that have recently disrupted healthcare access for civil servants.

According to a statement released on Sunday, the talks will focus on establishing new tariffs, refining service delivery frameworks, and streamlining claims management processes.

Consensus and Collaboration

The decision to initiate these talks follows extensive consultations between the Ministry of Health, the SHA, and several key stakeholders representing public sector workers. The negotiations involve:

• Government Bodies: The State Department for Public Service, the Teachers Service Commission (TSC), the National Police Service, and the Kenya Prisons Service.

• Labor Unions: The Kenya National Union of Teachers (KNUT), KUPPET, and the Union of Kenya Civil Servants (UKCS).

Officials have assured public officers that their medical cover benefits have not been reduced, despite the administrative adjustments and system transitions currently taking place.

Immediate Measures to Protect Beneficiaries

In a bid to stop the “friction” reported at hospital reception desks, the SHA has announced the immediate withdrawal of tariff locking in its digital systems. This temporary measure is designed to ensure that no civil servant is turned away or asked for cash payments while negotiations are ongoing.

Strict directives for healthcare providers include:

• Zero Out-of-Pocket Costs: Hospitals are strictly prohibited from charging beneficiaries any co-payments or extra fees during this interim period.

• Rapid Response Desk: A joint task force between SHA and UKCS has been established to intervene in cases where civil servants are detained in hospitals or to process refunds for unauthorized charges.

• Contract Risks: Facilities that fail to reach a consensus on the new tariffs at the end of the talks face immediate contract termination.

Accountability and Sustainability

To safeguard the integrity of the fund, the Ministry of Health warned that any facility found imposing unauthorized charges will face “swift enforcement action,” including being struck off the SHA network.

The SHA has also committed to stricter oversight, including regular claims audits to detect fraud and continuous monitoring of loss ratios. Civil servants are encouraged to consult the updated list of formally contracted facilities on the SHA website to ensure they are seeking treatment from approved providers.

The nationwide talks are expected to conclude with the signing of new, binding agreements that will stabilize the Public Officers Medical Scheme Fund for the long term.