NMa has revised its Guidelines for the health care industry
The Netherlands Competition Authority (NMa) today published a revised edition of its Guidelines for the health care industry. The NMa expects that this revised edition will clarify to health care providers, health insurers and other parties what types of collaboration agreements and conduct are allowed under the Dutch Competition Act. For the revision, the NMa has held extensive consultations with health care providers, health insurers, trade associations and other experts in order to have the guidelines better dovetail with the kinds of problems and questions that these parties have, and to be able to take into consideration specific characteristics and current developments.
Chairman of the Board of the NMa Pieter Kalbfleisch explains: 'Plenty of types of collaboration agreements in the health care industry are allowed, although we often hear signals from the health care market as if the Dutch Competition Act prohibited all forms of collaboration. What the Guidelines show is that this is only the case in a limited number of situations. We are in favor of forms of collaboration that increase the efficiency or quality of health care, provided that competition is not unnecessarily restricted, for example, by price-fixing agreements or market sharing.' In order to offer health insurers and health care providers more clarity, the revised guidelines make use of numerous new and concrete examples.
The Guidelines also cover the negotiation process between health insurers and health care providers, as well as situations in which abuse of a dominant position could occur. The NMa recently published a vision document (in Dutch) on this issue. The Guidelines also go into concentrations between undertakings, such as mergers and joint ventures.
The guidelines do not yet examine the developments in collaboration within health care groups. The NMa and the Dutch Healthcare Authority (NZa) are currently asking health care groups, health insurers and patient organizations for their input in connection with a consultation document (in Dutch) in which the NMa and the NZa explain in what ways the Dutch Competition Act and the Dutch Health Care Market Regulation Act (Wmg) apply to health care groups. Several specific questions have also been included in order to find out what continues to be unclear. The results of this consultation will be published later this year, and will be incorporated into the Guidelines.
The Guidelines also explain what the exact roles of the NMa and the NZa on the health care market are. The NMa assesses mergers and acquisitions in the health care market, and it enforces the prohibition of cartels. The NMa also takes action if it suspects a dominant position is possibly abused. In such situations, the NZa can also play a role. If it turned out that health care providers or health insurers have considerable market power, the NZa could impose obligations in order to prevent them from abusing that power. In other words: the NMa assesses ex post whether a dominant position has been abused, whereas the NZa's regulatory powers enable it to prevent abuse from occurring. In addition, the NZa sets rules, budgets and tariffs for the regulated segments of the health care market, and it sets conditions for the segments that have completely or partially been liberalized. In their assessments, the NMa and the NZa make use of each other's knowledge and expertise.
The Guidelines are an evolving document. The NMa is closely watching relevant developments in the health care market, as well as monitoring the most frequently asked antitrust questions. Wherever useful, it will incorporate these into the Guidelines. The Guidelines will also be used as the basis for a brochure that will be released in spring 2010. By publishing the Guidelines, the NMa has tried to provide a detailed and definitive reference work on antitrust-related questions. The yet-to-be-published brochure is intended for those that are not very familiar with antitrust rules, enabling them to improve their understanding of how the Competition Act works.
The Guidelines for the health care industry (in Dutch) can be found on the NMa's website: www.acm.nl.