Diederik Schrijvershof and Jeanne Plettenburg have helped Stichting GGNet (“GGNET”) successfully arrange additional contracting by Zilveren Kruis (“ZK”) at GGNet. GGNet was forced on 21 October 2019 to introduce a ban on new admissions for certain insured of ZK, on the grounds that the turnover ceiling imposed on GGNet by ZK had been reached and ZK, when asked, had not decided, also after a very long period, to procure additional mental healthcare at GGNet. The partial ban on new admissions led to reports in various media and to parliamentary questions. The Netherlands Healthcare Authority (“NZa”), which supervises the enforcement of the duty of care that exclusively applies to healthcare insurers, also became involved; see here and here.
Maverick Advocaten’s team advised GGNet on the contract with ZK and the NZa, among other things. The objective was to have ZK procure additional mental healthcare at GGNet by means of additional contracting in accordance with the statutory duty of care. GGNet and ZK reached agreement on this point in November 2019. In 2019, ZK will provide GGNet with the funds required to admit approximately 70 new patients. ZK will furthermore this year help to transfer some of its insured who require mental healthcare to other healthcare providers in the region.
As NZa found in May 2019, GGZ Netherlands has also drawn attention to the fact that timely additional contracting by healthcare insurers when turnover and other ceilings are about to be reached is a bottleneck that requires additional attention in healthcare procurement by insurers. More information on what the NZa (and you) can or must do with regard to waiting lists, bans and imminent bans on new admissions, and the duty of care can be found in this blog and this blog. More information on the rights of healthcare providers and the obligations of healthcare insurers in healthcare procurement can be found at www.zorgcontractering.com.