Diederik Schrijvershof has successfully filed three enforcement requests with the Dutch Healthcare Authority (NZa) on behalf of healthcare providers and their trade association regarding breaches of mandatory rules by three healthcare insurers.
In response to those requests, the NZa instituted two investigations of breaches of the NZa Healthcare Purchasing Process Transparency Regulations under the Healthcare Insurance Act by two different healthcare insurers. The healthcare insurers in question applied, among other things, a contract signing period that was foreseeably too short; also, they could not adequately be reached by healthcare providers during the 2019 contracting process. The pending investigation by the NZa may lead to fines being imposed on the healthcare insurers. The NZa previously fined another healthcare insurer on the grounds of breach of the Healthcare Purchasing Regulations. More information on this point can be found here, here and here.
The third request related to a healthcare insurer that had wrongly listed after 12 November 2018 numerous healthcare providers with which contracts had long since been entered into for 2019 as “uncontracted 2019” in its online CareFinder. That wrong-footed consumers in choosing their 2019 policy and distorted the level playing field between the healthcare providers. In doing so, the healthcare insurer breached the NZa rules on the provision of information by healthcare insurers to consumers. The enforcement request was reason for the healthcare insurer to change its online CareFinder. According to the NZa, the healthcare insurer in question had been called to account earlier in the year already for unclear communication. More information on these three cases of the NZa can be found here.
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. More information on the rights of healthcare providers and the obligations of healthcare insurers in healthcare purchasing can be found here or at zorgcontractering.com.