Diederik Schrijvershof is representing a trade association of healthcare providers in appeal proceedings brought by healthcare insurer VGZ to challenge the fine imposed on them by the NZa (Dutch Healthcare Authority) in 2020 for breaching healthcare contracting rules. The trade association is taking part in these proceedings as a third party.
These appeal proceedings follow the €100,000 fine imposed on VGZ by the NZa on 25 August 2020 for breaching the NZa Regulations on Transparency in the Healthcare Procurement Process under the Healthcare Insurance Act (the “Healthcare Procurement Regulations”). VGZ objected to the fine in 2020. On 2 June 2021, the NZa ruled in the objection procedure to uphold the fine imposed on VGZ. Maverick Advocaten successfully represented the trade association in those proceedings as well. VGZ filed an appeal against that decision on the objection with the Rotterdam Court in 2021. The case will be heard by the court in the spring of 2022. VGZ may appeal that decision before the Trade and Industry Appeals Tribunal.
Enforcement request submitted to the NZa
Diederik Schrijvershof submitted an enforcement request to the NZa in 2019 on behalf of a trade association of healthcare providers. That enforcement request followed various breaches by VGZ of the Healthcare Procurement Regulations and earlier formal NZa warnings given to VGZ for breaching the Healthcare Procurement Regulations. The NZa then decided that VGZ was indeed again in breach of the Healthcare Procurement Regulations. According to the NZa, VGZ's changes to the 2020 procurement policy and to the procedure for the purchase of healthcare are in breach of Article 7 of the Healthcare Procurement Regulations. The NZa imposed a fine of €100,000 in total on VGZ on that ground. The objection proceedings instituted by VGZ were unsuccessful. More information about this NZa fine decision can be found here, here, here and here.
Earlier enforcement by the NZa
In 2019, the NZa issued five formal warnings for breaches of the Healthcare Procurement Regulations by insurers. The NZa warned VGZ (twice), Zorg en Zekerheid, CZ and DSW on the grounds of established breaches of the Healthcare Procurement Regulations. The NZa had previously imposed a fine on DFZ (a division of healthcare insurer Zilveren Kruis) for a breach of the Healthcare Procurement Regulations. In 2019, the NZa furthermore repeatedly announced (see here and here) that it would take stricter action against (repeated) breaches of the Healthcare Procurement Regulations. Also in 2021, the NZa drew attention to the need for healthcare insurers to comply with the Healthcare Procurement Regulations when purchasing healthcare. In 2021, NZa warned EUCARE and again fined VGZ for breaches of the Healthcare Procurement Regulations.
Maverick Advocaten advocates enforcement of mandatory rules for healthcare insurers
For many years, Maverick Advocaten has advocated adequate mandatory rules (and the enforcement of those rules) for healthcare insurers in the purchase of healthcare and the tackling of excessive purchasing power of healthcare insurers. More information can be found here, here, here, here, here, here, here, here, here, here and here. More information on the rights of healthcare providers and the obligations of healthcare insurers can be found at zorgcontractering.com.
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