Diederik Schrijvershof and Annabel Kingma have submitted an enforcement request to the Dutch Healthcare Authority (“NZa”) on behalf of several GPs. The enforcement request related to a breach in 2021 by Zilveren Kruis of the NZa Regulations on Transparency in the Healthcare Procurement Process under the Healthcare Insurance Act (the “Healthcare Procurement Regulations”). The NZa found that, in breach of the Regulations, Zilveren Kruis had indeed failed to respond in a timely and adequate manner to questions and remarks from GPs regarding a contract that Zilveren Kruis uses in its GP care procurement in 2022 and 2023. The NZa gave Zilveren Kruis a formal warning on that ground. The warning means that if Zilveren Kruis breaches the transparency rules in Article 5 of the Regulations again within two years in the procurement of care, the NZa will, in principle, take formal measures against it, such as an instruction or an administrative penalty. The decision on the enforcement request can be found here.
NZa Healthcare Procurement Regulations
The NZa previously fined DFZ, a division of Zilveren Kruis, for breaching the Healthcare Procurement Regulations. More information can be found here, here and here. The NZa also issued various formal warnings for breaches of the Healthcare Procurement Regulations by insurers. It warned, for instance, Zorg en Zekerheid, CZ, VGZ (three times) and DSW about breaches of the Healthcare Procurement Regulations. In 2019, the NZa announced (see here and here) that it would take tougher action against (repeated) breaches of the Healthcare Procurement Regulations. VGZ ignored two formal NZa warnings and again breached the Healthcare Procurement Regulations in 2019, to the detriment of healthcare providers. The NZa fined VGZ in 2020 and imposed a second fine on VGZ at the end of 2021 for breaches of the Healthcare Procurement Regulations.
For many years, Maverick Advocaten has advocated the introduction and enforcement of adequate mandatory rules for health insurers in healthcare procurement, and the tackling of excessive market power of health insurers. More information can be found here, here, here, here, here and here. More information on the rights of healthcare providers and the obligations for healthcare insurers can be found at zorgcontractering.com.