Maverick Advocaten successful with tackling abuse of procurement power health insurers: NZa warns insurers

Diederik Schrijvershof and Jeanne Plettenburg successfully assisted the association for orthopaedic devices, NVOS-Orthobanda (“NVOS”), with two requests for enforcement at the Dutch healthcare authority (“NZa”). In 2018 insurers VGZ and DSW violated mandatory rules concerning healthcare purchasing to the detriment of members of NVOS. Earlier this year, the NZa issued administrative warnings to DSW and VGZ:

  • On the 1th of April VGZ published an incomplete timeframe in its healthcare purchasing policy. In addition, the insurer failed to amend this policy in a timely and substantive manner. For both violations of the Regulation for transparency in healthcare purchasing (“Healthcare Purchasing Rules”), the NZa issued a warning during the objection procedure to VGZ. This warning included that VGZ would be administratively fined if it would violate article 4 and/or article 7 of the Healthcare Purchasing Rules another time in 2019.
  • After the 1th of April, DSW wrongfully adjusted its purchasing policy of 2019. The Healthcare Purchasing Rules presecribe, inter alia, that making amendments to the purchasing policy are only possible in certain circumstances. The amendment made by DSW was, contrary to what the NZa rules prescribe, not implemented in a timely manner and insufficiently motivated. Furthermore, the amendment was not properly communicated to healthcare providers. The NZa issued an administrative warning to DSW, stating that DSW will be administratively fined if it will violate article 7 of the Healthcare Purchasing Rules again in 2019 when purchasing orthopaedic devices.

The NZa has issued a warning to CZ for a similar violation. Furthermore, the NZa announced that it will take “tougher action against violations” of the Healthcare Purchasing Rules with regard to healthcare purchasing process of 2020. The NZa is still working on an enforcement process with regard to another insurer. The healthcare providers in this case are also assisted by Maverick Advocaten. It is to be expected that the NZa will impose a fine on this other insurer for violations of the Healthcare Purchasing Rules in the second half of 2019. Such fines were earlier imposed on the Friesland Zorgverzekeraar, which is part of Zilveren Kruis. See here, here, here and here for more information about this case.

For many years already, Maverick Advocaten has advocated adequate mandatory rules (and enforcement of those rules) for healthcare insurers in healthcare purchasing and tackling of excessive procurement power of healthcare insurers. More information on that point can be found here, here, here, here and here. For more information about the rights of healthcare providers and the obligations of healthcare insurers in healthcare purchasing, see our 12 steps to make sure to be well prepared for the healthcare purchasing process of 2020 or visit zorgcontractering.com.

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Contact details

Diederik Schrijvershof

T +31 20 238 20 03
M +31 6 81 364 318

Jeanne Plettenburg

T +31 20 238 20 09
M +31 61 341 70 71