Diederik Schrijvershof, Leah Peeters and Annabel Kingma achieved further success for healthcare providers in appeal proceedings relating to the selective 2024 and 2025 primary care diagnostics procurement policy of health insurer Zilveren Kruis (ZK). Primary care diagnostic services are provided by independent laboratories and hospitals. ZK organised a selective procedure in 2023 for the procurement of such diagnostic services in various regions in the Netherlands for the purpose of a multi-year primary care diagnostics contract.
The appeal proceedings centred on two questions:
- Should ZK pass on the government contribution to the labour cost development in the primary care diagnostics reference rates in line with the Comprehensive Care Agreement?
- Should ZK index the primary care diagnostics reference rates for the increased cost of goods and capital?
The preliminary relief judge of the District Court of The Hague ruled on 12 October 2023 already that ZK had to incorporate the labour costs development in the 2024 and 2025 reference rates (see also here). The diagnostic service providers’ claim that the rates for the goods and capital items should also be indexed was rejected. Both ZK and the diagnostic service providers then filed on appeal with the Court of Appeal of The Hague.
The Court of Appeal of The Hague delivered its judgment on 11 June 2024. It ruled in favour of the diagnostic service providers. ZK must include both (i) the labour costs development and (ii) an indexation for costs of goods and capital in the 2024 and 2025 primary care diagnostics rates. If ZK fails to do so in a timely manner, it will forfeit a penalty of up to EUR 1 million.
Maverick Advocaten assists healthcare providers on a daily basis to achieve cost-covering healthcare rates or to challenge inadequate turnover and other caps. It is successfully litigating, for instance, on behalf of Stichting De Bevlogen Huisartsen and 129 individual GPs against the GP Care and Multidisciplinary Care Rates Decision 2023 before the Dutch Trade and Industry Appeals Tribunal (see here). Maverick Advocaten is also litigating on behalf of providers of forensic mental healthcare against the NZa 2023 and 2024 Mental Healthcare and Forensic Care Rates Decision. Previously, Maverick Advocaten achieved successes in preliminary relief proceedings for healthcare providers in the procurement of, among other things, primary diagnostics, GP care, acute mental healthcare (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 also here).
Maverick Advocaten also challenges excessive market power of health insurers (see also here). It furthermore helps care providers with NZA enforcement requests regarding the duty of care/care procurement duty of all health insurers. More information on the duty of care/care procurement duty can be found in this blog and this blog.
More information on the rights of healthcare providers in healthcare sales and the possibilities for their industry associations to support them in this regard can be found at www.zorgcontractering.com.
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