Diederik Schrijvershof and Leah Peeters have successfully litigated on behalf of two mental healthcare providers to challenge the 2024 long-term care procurement policy of a large care administration office. The office was forced to adjust its 2024 long-term care procurement policy as a result of the preliminary relief proceedings. This was reason for the two mental healthcare providers to withdraw the action.
This case followed the successful preliminary relief proceedings earlier this year by seven care providers (Emergis, Parnassia Groep, GGZ WNB, GGzE, GGz Breburg, GGZ Oost Brabant and Mondriaan) against the CZ care administration office’s long-term mental healthcare procurement plans. The CZ care administration office expressly refused to heed their substantiated objections. At the same time, proceedings instituted by the CZ care administration office were conducted in which going to court was the only option available to the care providers.
The CZ care administration office planned to pay for clients with long-term care needs who live in sheltered accommodation at a mental healthcare provider only on an integral basis (residential care, mental healthcare treatment and general medical care all being funded under the Long-Term Care Act). Previously, modular funding had been possible (with residential care falling under the Long-Term Care Act and mental healthcare treatment and general medical care under the Healthcare Insurance Act). For providers of sheltered accommodation, the abrupt switch would mean that, in order to protect their clients’ freedom of choice of treatment provider, they would have to enter into subcontracts with numerous primary care providers in the short term, resulting in a large administrative burden. CZ furthermore introduced a 20% discount on the housing component of the care profiles Living 1 and 2 as from 1 January 2024. That would lead to unrealistic and non-cost-effective rates.
The Court of The Hague ruled in favour of the mental health organisations in preliminary relief proceedings. The court annulled the proposed integral financing and the proposed discount on the rates. With regard to the switch to integral funding, the court found that CZ was acting outside the limits of its policy freedom. The mental healthcare providers are therefore free to opt for a modular funding model until 1 January 2025. The court also deemed the discount disproportionate and considered it insufficiently plausible that the discount would effectively contribute to stimulating the use of care, counselling and support in the home environment. CZ did not appeal the ruling.
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 litigating, for instance, on behalf of providers of forensic mental healthcare against the NZa’s 2023 Mental Healthcare and Forensic Care Rates Decision. Maverick Advocaten is also litigating on behalf of De Bevlogen Huisartsen, a foundation, and 129 individual GPs against the NZa’s 2023 GP Care Rates Decision. Previously, Maverick Advocaten achieved successes in preliminary relief proceedings for healthcare providers in the procurement of, among other things, 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.
More information on the healthcare procurement duty/duty of care and its enforcement is provided in this blog, this blog and this interview in Zorgvisie. 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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