The Social Health Authority (SHA) has begun implementing revised hospital tariffs under the Public Officers Medical Scheme Fund (POMSF), marking the start of a phased rollout aimed at standardising payments across public healthcare facilities.

According to the Authority, the process follows a mandatory market analysis and structured negotiations with healthcare providers before final approval and full implementation.

SHA referenced Clause 10.2(c) of the POMSF Addendum, which states that, “the Authority shall conduct a market analysis during the first three (3) months of the commencement of the POMSF Scheme and, following negotiations with healthcare facilities, provide final tariffs subject to approval by the SHA Board.”

In line with this provision, the Authority confirmed that it has already initiated the market analysis and tariff negotiations under the POMSF framework.

SHA Chief Executive Officer Mercy Mwangangi said discussions with Level 5 and Level 6 healthcare facilities have been concluded, paving the way for the next phase targeting Level 4 and Level 3 hospitals.

“The approved POMSF tariffs will be implemented progressively in the SHA claims system by hospital level and package, and shall apply to service access, claims submission, adjudication, and reimbursement under POMSF,” Mwangangi said.

She added that facilities that have agreed to the negotiated tariffs will continue offering services to POMSF beneficiaries in accordance with the approved benefit package and reimbursement terms.

The Authority noted that the process is expected to be largely finalised within the next 21 days, depending on the outcome of ongoing engagements with healthcare providers.

For support or clarification, healthcare providers have been advised to contact their respective SHA county offices or reach the Authority’s contact centre.