A team of Maverick Advocaten has successfully submitted an enforcement request to the Dutch Healthcare Authority (NZa) on behalf of a healthcare provider. The enforcement request related to excessive purchasing power of a health insurer in the healthcare procurement process. In 2021/2022, health insurer VGZ violated the NZa Regulations on Transparency in the Contracting Process under the Long-Term Care Act (the Healthcare Procurement Regulations) by failing to clearly respond in a timely manner to questions from the care provider about the VGZ contract offer for 2022 (including a turnover cap). VGZ is obligated to do so under Article 5 of the Healthcare Procurement Regulations. Following an investigation, the NZa concluded that VGZ had indeed violated the Healthcare Procurement Regulations by failing to respond in time. The NZa imposed a formal warning on VGZ for that violation. The warning states that if VGZ violates Article 5 of the Health Procurement Regulations again within two years, the NZa will, in principle, take formal measures, such as an instruction or an administrative penalty.
NZa Healthcare Procurement Regulations
This is the third formal warning that the NZa has given to VGZ for violating the Healthcare Procurement Regulations. The NZa had already warned VGZ (twice). VGZ ignored these warnings and violated the Healthcare Procurement Regulations again in 2019, to the detriment of healthcare providers. The NZa subsequently fined VGZ in 2020 and imposed a second fine on it at the end of 2021 for violations of the Healthcare Procurement Regulations. The NZa had previously also fined DFZ, a division of Zilveren Kruis, for a violation of the Healthcare Procurement Regulations. Read more about this here, here and here. The NZa issued formal warnings for violations of the Healthcare Procurement Regulations to other health insurers as well. It warned EUcare, Zorg en Zekerheid, CZ and DSW, for instance, for violations of the Healthcare Procurement Regulations. In 2019, the NZa announced that it would take tougher action against (repeated) violations of the Healthcare Procurement Regulations.
Maverick Advocaten has campaigned for many years for adequate mandatory rules, and the enforcement of those rules, for health insurers in healthcare procurement, and for tackling excessive purchasing power of health insurers. More information can be found here, here, here and here. More information on the rights of healthcare providers and the obligations for health insurers, can be found at zorgcontractering.com.