More than 4 billion tenge could have gone to unjustified payments in the mandatory social health insurance (OSMS) system. However, violations were detected before funds were transferred thanks to digital anti-fraud mechanisms. This was reported by Qazaqyia.kz citing Kursiv Media.
The OSMS reform started in February 2026 after the transfer of the Social Health Insurance Fund to the Ministry of Finance. One of the main principles of the changes, according to the ministry, is the shift from post-payment checks to preventing violations before payments are made.
"For example, if earlier payment checks were carried out post factum – after the money had already been sent – now unjustified payments are prevented before payment. As a result, in the first half of 2026, the anti-fraud system identified defects worth more than 4 billion tenge before the corresponding funds would have been transferred to medical organizations," the Ministry of Finance stated.
In parallel, healthcare financing is being transferred to a unified digital circuit on the Qalqan platform. The pilot project in Astana involves 207 clinics.
Through the system, 20 out of 92 types of medical care are already being paid for, and testing is underway for another 60 areas. By the end of the year, all declared types are planned to be put into industrial operation.
Digitalization also affects patients. In eGov Mobile, it is already possible to confirm a visit to a medical organization using a QR code.
In the future, an electronic financial passport of the patient will appear with information about medical services provided and paid for.
In the second half of 2026, the FSMS plans to scale up the new model. The main focus is on transparency of financing, accessibility and effectiveness of medical care, as well as clear rules for doctors.
Earlier, Kursiv reported that the FSMS expanded the Qalqan pilot to 16 medical organizations and introduced a "red button."
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