Diederik Schrijvershof and Leah Peeters achieved success on behalf of NVOS-Orthobanda (“NVOS”) with an enforcement request to the Dutch Healthcare Authority (“NZa”). With this request, the NZa was asked to enforce the Regulation on transparency of the healthcare purchasing process Zvw (“Healthcare Purchasing Regulation”). In response to the request, the NZa conducted an investigation and determined that VGZ did not provide sufficient justification for the contract offer 2025 et seq. in violation of article 6.3 of the Healthcare Procurement Regulation. In this context, the NZa has imposed a formal warning on VGZ. Should VGZ once again violate article 6.3 of the Healthcare Procurement Regulations in the coming years, the NZa may act with a fine.
NZa Healthcare Procurement Regulations
The fact that the health care insurer must motivate in a timely and sufficiently clear manner why a discount is used in a contract offer by the insurer is an important issue for care providers in practice. This all the more so because it follows from the Star ruling that healthcare purchasers must at all times take into account the legitimate interests of healthcare providers and in that context may not systematically refuse to not index contracts. Read more about the Star ruling here. The NZa has previously (such as here and here) made it known to take tougher action against (repeated) violations of the Healthcare Procurement Regulations. VGZ was warned twice before by the NZa for a violation of the Healthcare Procurement Regulations. VGZ ignored two formal NZa warnings and again violated the Healthcare Procurement Regulations to the detriment of healthcare providers in 2019. The NZa then fined VGZ in 2020 and issued a second fine to VGZ at the end of 2021 for violations of the Healthcare Procurement Regulations.
The NZa also issued several formal warnings to other health insurers in the past for violations of the Healthcare Procurement Regulations. For example, the NZa warned Zorg en Zekerheid, CZ, Zilveren Kruis, Menzis, EUCARE and DSW for violations of the Healthcare Procurement Regulations. Zilveren Kruis was also fined.
For years, Maverick Advocaten has been advocating adequate (enforcement of) mandatory rules for health insurers in healthcare procurement and tackling excesses of purchasing power of health insurers. For more information see here, here, here, here, here , here, here, here and here. For more information on the rights of healthcare providers and duties for healthcare insurers consult www.zorgcontractering.com.
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