Diederik Schrijvershof is representing a care provider faced with a too low turnover ceiling imposed by the health insurer. With the assistance of Maverick Advocaten, the care provider requested the NZa (Netherlands Healthcare Authority) to take enforcement action on that ground. The NZa ensures that insured persons do not have to wait too long before receiving care. That is foreseeable in this case, and the care provider wishes to shorten the waiting list.
The NZa has published guidelines for the implementation of the duty of care that health insurers may use to properly implement the duty of care (Article 11 of the Zorgverzekeringswet (Healthcare Insurance Act)). Maverick Advocaten is helping the care provider make agreements with the health insurer to avoid a situation in which it is forced to stop accepting new patient applications. More information on how to deal with inadequate care turnover ceilings, waiting lists, the suspension of the acceptance of new patient applications and the NZa’s role in this regard can be found here.
Maverick Advocaten regularly represents healthcare providers in healthcare contracting; see also here. Maverick Advocaten has furthermore advocated better rates in the healthcare sector for many years. It has also successfully conducted legal proceedings in the past on behalf of healthcare providers regarding the procurement of acute mental healthcare (see here and here), forensic care, youth care, SGLVG (Serious Behavioural Problems and Mild Intellectual Disability) care, long-term care (also on appeal) and care under the Social Support Act (see here), and against excessive purchasing power of healthcare insurers.
More information on the rights of healthcare providers in healthcare sales and the ways in which their trade associations can support them can be found at www.zorgcontractering.com.
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