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NMa Sees Opportunities for Healthcare Brokers

Healthcare brokers can play an important role in negotiations between healthcare providers and health insurers. This appears from the supplement to the Healthcare Sector Guidelines adopted by the Netherlands Competition Authority (NMa). This amendment sets out the opportunities for healthcare providers to negotiate with the assistance of a healthcare broker within the framework of the Competition Act.

A healthcare broker acts as an intermediary between a healthcare provider, such as a general practitioner or physiotherapist, and a health insurer during contractual negotiations. By doing so, the healthcare broker can relieve the healthcare provider of considerable administrative work. The healthcare broker gives the healthcare provider with advice and assistance. These activities may relate to each part of the contract.

The new guidelines indicate what is and is not permitted in terms of the Competition Act on the basis of concrete examples. The following are several examples of what is permitted:

  • Practitioners of liberal professions within a single undertaking, for instance a partnership, may negotiate with the assistance of a single healthcare broker.
  • A group of competing healthcare providers, who remained below is the de minimisceiling, a may negotiate with the assistance of a single healthcare broker. A maximum of eight competing undertakings with a joint turnover of EUR 908,000 or less fall below thede minimisceiling.
  • Healthcare providers who are active in separate geographical or product markets (for instance, physiotherapists and general practitioners), may negotiate with the assistance of the same healthcare broker. They may negotiate with health insurers about tariffs and commercial conditions as a group with the assistance of the healthcare broker. Since they do not compete with each other, they may negotiate together through the same healthcare broker.
  • Competing healthcare providers negotiate with the assistance of a healthcare broker and comply with the conditions set out in the guidelines. These conditions are meant to ensure that the activities of the healthcare broker do not result in a situation where sensitive competitive information is exchanged between healthcare providers and where the coordination of behaviour can occur.

Anti-competitive agreements and practices are prohibited by law. For instance, the use of a healthcare broker may not result in the exchange of sensitive competitive information between competing undertakings which do not fall below thede minimisceiling.

René Jansen, a member of the Board of Directors of NMa: 'Healthcare brokers can relieve healthcare providers of a considerable administrative burden. This is a qualitative advantage. In addition, healthcare providers can join forces on different geographical and product markets through the healthcare broker. This is also an advantage. For instance, they may adopt a strong negotiating position in relation to health insurers".

In amending the guidelines, NMa took as its point of departure existing practice in the Netherlands. It also considered the experience of the American anti-trust regulator, the Federal Trade Commission (FTC). In this regard, the United States has the so-called 'messenger'.

In 2006, the healthcare sector is one of NMa's priorities. In the future, NMa will continue to monitor the market and amend the healthcare guidelines in line with developments in practice.