NMa Approves Guidelines for the Healthcare Sector

The Netherlands Competition Authority (NMa) has approved the definitive guidelines for the healthcare sector. The guidelines describe clearly what agreements restrain competition and, in principle, are prohibited, such as agreements on prices and tariffs, agreements to divide markets and co-ordinated boycott campaigns. Such agreements reduce the variety of healthcare on offer and detract from consumers' freedom of choice. With the help of these guidelines, professional practitioners, health insurers and other entrepreneurs in the healthcare sector can independently assess the forms of co-operation they enter into and their practices against the Competition Act.

The guidelines were drawn up after various interested parties had given their responses to draft guidelines published on 28 March 2002. At the request of various branch organisations, including MKB Nederland (representing small and medium-sized enterprises) and Landelijke Huisartsenvereniging (LHV) [ Netherlands Association of Doctors], a number of improvements were made to the structure and ordering of the guidelines.

The Competition Act also imposes limitations on companies with an dominant position. A health insurer, for instance, with a dominant position may not abuse this position by discriminating against healthcare providers or by refusing to enter into a contract with a healthcare provider without giving an objective justification for this. Health insurers with a dominant position are obliged to draw up objective, transparent and non-discriminatory criteria when negotiating contracts with healthcare providers. The health insurer, however, is not obliged to enter into contracts with everyone.

In its guidelines, NMa has indicated that where co-operation enhances efficiency and quality, agreements between companies in the healthcare sector are to the advantage of consumers, provided competition is not restrained unnecessarily. Such agreements could include agreements which promote the level of quality, such as joint locum tenens arrangements and the creation of joint electronic customer databases. Such schemes may not be abused to exclude competitors.

NMa has processed a total of 390 cases in the healthcare sector. The guidelines for the healthcare sector set out the substantive line which emerges from the rulings in these cases.

The guidelines for the healthcare sector and background information can be obtained from NMa's website: www.nma-org.nl (external website) .