House doctors underpaid because Dutch regulator set rates too low, Dutch court rules

The Dutch Healthcare Authority (NZa) is required to reassess the fees GPs can charge for their services. The Administrative Jurisdiction Division of the Council of State (CBb) ruled that the authority did not adequately demonstrate that the rates set for 2023, 2024, and 2025 cover costs.

The case was initiated by the National General Practitioners Association (LHV), the Association of Practicing GPs (VPH), and the De Bevlogen Huisartsen (DBH) foundation, who argue that the fees set by the NZa are too low.

Disputes over GP fees have occurred repeatedly in recent years. In late 2023, the CBb ruled in favor of the GPs, agreeing that the NZa should not have relied on an outdated cost study to set the rates.

Following this, the NZa conducted a new study, which the CBb deemed valid for setting the fees. However, the CBb now rules that when recalculating the rates, the NZa failed to demonstrate that they adequately cover the reasonable costs GPs face in delivering care.

The Council clarifies that this concerns, in part, funding for GP practice premises. “Many GP practices are located in spaces that are too small. The NZA’s fee decisions fail to account for the extra costs required to adapt these premises or to secure new locations for practices that have expanded.”

The LHV describes the ruling as crystal clear. “The CBb has once again confirmed that the fees systematically fail to cover the true costs of providing GP care.”