NMa: Negotiations with the Regional Representative in Relation to the Budget Is beyond the Scope of the Competition Act

The Competition Act does not apply to negotiations between hospitals, the dominant health insurer in the region and the regional representative. Health insurers may negotiate jointly through a regional representative because this is necessary at the moment in determining the budgets of healthcare institutions in the so-called A segment.

This emerges from an informal opinion which the Netherlands Competition Authority (NMa) has drawn up at the request of the Medical Charges Board/Office of Health Regulation, which is currently being set up.

Joint consultations between insurers and healthcare institutions result in agreements on production and capacity. The regional representative represents all health insurers, except the insurer with the largest market share, which participates directly in the negotiations. On the basis of these negotiations, the Medical Charges Board/Office of Health Regulation determines the budget per hospital. In the so-called A segment, with regulated competition, health insurers are no longer obliged to enter into a contract with each healthcare institution (and vice versa).

NMa concludes that the joint consultations arise from the Healthcare Charges Act [Wet Tarieven Gezondheidszorg (WTG)] and that the Competition Act does not apply to this.

Healthcare is a priority in NMa's Agenda 2006. This year NMa will also be alert to reports which it receives and will continue to monitor the healthcare market actively. NMa will cooperate with the Medical Charges Board/Office of Healthcare Regulation in carrying out its regulatory duties.