Family doctors win court case forcing Dutch authority to reconsider rates & fees

The rates that general practitioners in the Netherlands charge for the care they provide must be re-evaluated, a tribunal court ruled on Thursday. The ruling was issued in a case filed by a large group of physicians who had objected to the rates that the Dutch Healthcare Authority (NZa) set for this year and 2024.

The court in The Hague ordered the NZa to take another look at the rates offered, and said the authority was no longer allowed to base its decisions on a cost analysis conducted in 2015. To determine the rates, the NZa looked at the costs incurred by the professional group in that year, and adjusted then adjusted the rates for for inflation.

The ruling was issued by the Trade and Industry Appeals Tribunal, or CBb, which is the highest court in cases related to socio-economic administrative law, and cases linked to the Competition Act or Telecommunications Act.

During the case, the organization De Bevlogen Huisartsen had argued that the study from eight years ago was no longer valid. For example, the costs for staff and accommodation have risen sharply and the general practitioner was also given a more demanding task. For example, care has been added for patients with coronavirus complaints and Long Covid, and the family doctors now also have a more important role in psychological care, the plaintiffs argued.

Another argument that the doctors used is the 2018 agreement that general practitioners spend more time during patient consulations.

The NZa pointed out that both the turnover and profit of general practices have increased, so these physicians' offices should not be facing financial problems. The healthcare authority also said it understands that the sector has changed in recent years.

The CBb ruled that "it cannot currently be objectively determined whether the 2023 and 2024 rates are cost-covering." This does not immediately mean that those rates have to increase, but it does mean that the NZa has to look at it again. The judges agreed with the plaintiffs that these rates were not established in the correct manner.

Many general practitioners were following the legal proceedings closely. The case involved 129 individual doctors. The National Association of General Practitioners (LHV) and the Association of Practicing General Practitioners (VPH) were also parties in the lawsuit.