Key Benefits:
Law of 7 July 2006 laying down rules on the organisation of the market, efficiency and management of costs in the field of health care (Law on the market in health care)
We Beatrix, at the grace of God, Queen of the Netherlands, Princess of Orange-Nassau, etc. etc. etc.
All of them, who will see or hear these, saluut! do know:
In this regard, we have taken the view that it is desirable to lay down rules on the development and organisation of health and health markets, including in order to ensure an effective and effective system of health care. and control of the cost development of care, and that it is also desirable to protect and promote the consumer's information disadvantage and the balance of power between the parties in the care, the position of the consumer;
In this way, we, the Council of State, and with the mean consultations of the States-General, have been well-regarded and understood to be right and to be understood by the following:
For the purposes of this Act and the provisions based thereon, the following definitions shall apply:
a. Our Minister: Our Minister of Health, Welfare and Sport;
b. Care:
1 °. care or service as defined by or under the Health insurance law and the Long-term care law ;
2 °. health care operations as referred to in Article 2 (2). Article 1, 1st paragraph, of the Act on the professions in the individual health care , where carried out, whether or not under its own responsibility, by persons, registered in a register as referred to in Article 3 of that Act or by persons as referred to in Article 34 of that Act and in so far as those operations are not included under 1 °;
c. healthcare provider:
1 °. the natural or legal person providing professional or business care;
2. the natural or legal person to the extent that these charges will be charged on behalf of, for the benefit of, or in connection with the provision of care by a healthcare provider, as referred to below 1 °;
d. health insurer: a health insurer as intended in the Health insurance law ;
e. Wlz exporter: a legal person as defined in Article 1.1.1 of the Act for long-term ;
f. Health insurer:
1 °. a health insurer;
2 °. A Wlz execre;
3. a private health insurance company, being a financial undertaking which is responsible for the Law on financial supervision the holding of insurer in the Netherlands,
g. insured person: the person who has entered into an insurance contract relating to the risk of sickness with a health insurer or is insured under the law of the law Long-term care law ;
h. insured person: the person who is the person who is responsible for the Article 2 of the Zorginsurance Act be required to ensure or ensure that they are insured under a health insurance policy;
(i) consumer: insured person, insured or patient;
j. performance: the delivery of care by a healthcare provider as referred to in subparagraph (c) below, below 1 °;
k. rate: price for a performance, a part of a performance or a set of performance of a healthcare provider;
l. care authority: the Dutch Zorgauthority, named in Article 3 ;
m. Zorginstitute: the Zorginstitute Netherlands, named in Article 58, first paragraph, of the Zorginsurance Act ;
n. College construction: the College Building Care Institutions, named in the Health care institutions Act ;
o. College remediation: the College remediation care institutions, named in the Health care institutions Act ;
p. FIOD-ECD: The Tax Administration/Tax Intelligence and Investigation Service and Economic Control Service of the Ministry of Finance;
q. ZorgInsurance Fund: the fund, named in Article 39 of the Zorginsurance Act ;
r. the CAK: the CAK, mentioned in Article 6.1.1, first paragraph, of the Act on long-term care .
1 In the case of a general measure of administration, if necessary for the proper implementation of this Act, work wholly or partly in the field of health care, or in whole or in part for the purposes of health care, may be shall be designated as a concern within the meaning of this Act.
2 In the case of a general measure of management, a form of care may be exempted from this Act or any part thereof.
3 This Act does not apply to a healthcare provider to the extent that this youth aid as intended Article 1.1 of the Youth Act offers.
4 This Act does not apply to:
a. Providers as intended Article 1.1.1 of the Social Support Act 2015 ;
b. third parties whose client is provided with a personal budget within the meaning of that Act, the services, instrumentalities, housing adjustments and other measures that are part of the measurement of employment.
1 There is a Dutch Zorgauthority, which has legal personality.
2 The care authority is established in a place to be determined by Our Minister.
3 The care authority shall be responsible for the tasks assigned to it by or under the law.
4 The care authority shall, in the performance of its tasks, lead the general consumer interest.
5 The health authority shall be represented in and out of court by the Chair.
6 The Framework Law on self-employed administrative bodies is applicable to the care authority, except for Article 17 of that Act .
1 The care authority shall be composed of a maximum of three members, including the Chairperson.
2 Appointment shall take place on the basis of the expertise necessary for the performance of the duties of the care authority and on the basis of social knowledge and experience.
3 Members shall be appointed for a maximum period of four years. Reappointment may take place twice and each time for a maximum of four years.
4 The members of the care authority do not have any financial or other interests at any institution or business that may compromise their impartiality.
1 The care authority shall establish a governing rules of procedure.
2 Meetings of the Care Authority shall not be public, except as provided otherwise in the Board of Procedure.
3 In any case, the care authority shall determine how it complies with the obligation under the rules of management. Article 3: 2 of the General Administrative Law Act .
1 Our Minister may issue a general indication to the Care Authority regarding:
(a) the subjects on which the care authority has jurisdiction under this Law to lay down rules;
(b) The matters concerning which the care authority is empowered under this Act to adopt policy rules.
2 Our Minister may provide, in a designation as referred to in paragraph 1 (b), that the care authority shall be of the order of its own motion a tariff as referred to in Article 4 (2). Article 50, first paragraph, part b or c , or determines a performance description.
3 A designation does not concern an individual healthcare provider, health insurance provider, or consumer.
Before our Minister in accordance with Article 7 (b) (b) , a designation shall, in writing, inform the two Chambers of the States-General of the relevant business content of the proposed act. It shall fix the decision not earlier than after 30 days after that communication. Our Minister makes a statement by placing it in the Official Gazette.
1 The health authority shall send a programme of work for the following calendar year to our Minister, together with the budget, for the following calendar year, describing the activities which the care authority intends to undertake in order to implement its tasks to perform.
2 Without prejudice Article 27 of the Framework Law on independent administrative bodies the budget shall contain a multi-annual estimate of the management costs for the four calendar years following the financial year.
1 The budget for the management costs of the health authority for the following calendar year shall be adopted by the Minister on an annual basis before 1 December.
2 Our Minister may decide to change the budget for the management costs of the care authority.
3 The healthcare authority does not commit to and does not incur expenditure resulting in overrun of the established budget for the management costs.
4 If the budget for administrative costs has not been fixed for 1 January of the calendar year to which the budget relates, the care authority shall be empowered to have at its disposal a maximum of one third of its activities, in order to keep its activities going. part of the budget that was last established for an entire year.
5 Our Minister may decide that, in a case as referred to in paragraph 4, the health authority may have more than one third of the budget which was last laid down for an entire year.
6 The budget allocated by Our Minister for the management costs of the care authority is covered from Rijks greenhouse.
1 The work programme referred to in Article 11 The approval of our Minister needs to be approved.
2 By way of derogation from Article 29 of the Framework Law on independent administrative bodies , amendments to an approved budget do not have to approve our Minister, provided that:
a. the total size of the budget does not undergo any change; and
b. the change by group of cost categories and benefits, calculated in respect of the financial year in question, amounts to five per cent of the Article 12 That budget does not exceed the budget.
3 Under ministerial arrangements, rules may be laid down on:
a. the content and establishment of the work programme referred to in Article 11 ;
(b) the content and establishment of the annual report, the budget and the annual accounts referred to in the Article 18 , 26 and 34 of the framework law independent administrative bodies ;
Audit auditing of the annual accounts;
d. the size of the equalization reserve, as specified in Article 33 of the Framework Law on independent administrative bodies .
4 By ministerial arrangement rules are laid down on the manner and conditions under which the budget, referred to in Article 12 shall be established.
5 Without prejudice Article 35 (4) of the Framework Law on independent administrative bodies The auditor shall also report on its findings as to whether the management and organisation of the care authority comply with the requirements of lawfulness, ordability and controllability.
1 After the approval, referred to in Article 14, first paragraph , of this law and in the Article 29, first paragraph , and 34, second member, of the framework law on self-governing bodies , the Health Care Authority shall publicly available the work programme, the budget, the annual report and the annual accounts.
2 Our Minister shall inform both Chambers of the States-General of his judgment on the functioning of the health authority.
The care authority shall be responsible for:
a. market surveillance, market development and rate and performance regulation, in the field of health care;
Supervision of the lawful execution by the health insurers of what is at or under the Health insurance law is regulated;
c. Supervision of the lawful reckoning of contributions intended in the Articles 32 to 34 of the Zorginsurance Act , after an insurer has ceased to perform health insurance;
d. Supervision of the lawful and effective execution by the Wlz performers and the CAK of what is at or under the Long-term care law and the Articles 91, second paragraph, second sentence , 123 and 124 of the Social Insurance Financing Act is regulated;
e. supervision of the implementation of the Articles 41 , 42 and 43 ;
f. oversight of the lawful and effective execution by the CAK of what is at or under Article 118a of the Zorginsurance Act and Article 2.1.4 of the Social Support Act 2015 is regulated;
g. the task, intended to Article 28, second paragraph, part a, of the Law quality, complaints and disputes care ;
g. Monitoring of compliance with Article 66d, second paragraph, of the Zorginsurance Act ;
h. [ Red: this part has not yet entered into force;]
i. [ Red: this part has not yet entered into force;]
j. the task referred to in Article 60a, second paragraph, part a, of the Customer Rights Act.
1 With a view to effective and efficient decision-making on the method of dealing with matters of mutual interest and the collection of information for the purpose, agreements shall be agreed between the care authority and:
a. The Consumer Authority and Market Authority;
b. The State Supervision of Public Health;
c. De Nederlandsche Bank;
d. the Foundation Financial Markets Authority;
e. the ZorgInstitute;
f. College construction;
g. The reform of the College;
h. FIOD-ECD;
i. the College of Prosecutors-General of the Public Prosecution Service
j. College protection personal data;
k. Our Minister, for as far as it is concerned with the supervision of the CAK.
2 The arrangements shall in any event not require a governing body to require third parties to provide information where one of the other administrative bodies referred to may provide the necessary information.
1 The healthcare authority and the Authority shall promote consumer and market stakeholders first to the care authority in matters where there is a possibility of confration of competences.
2 Van aggregation of powers referred to in paragraph 1 shall be in a situation where the possible exercise of powers of the care authority on the basis of Article 48 of this law and the possible exercise of powers of the Consumer and Market Authority on the basis of the Competition law Whether European laws or regulations coincide or coincide.
3 The care authority shall, as far as possible, apply, as far as possible, the powers conferred on it under this Law before the Consumer and Market Authority has the powers conferred on it by the Authority on the basis of the Competition law apply.
4 The healthcare authority focuses on the interpretation of concepts used by the Consumer and Market Authority in the context of the application of competition law.
5 It is possible to derogate from the third paragraph where the care authority and the Authority and the Authority in joint consultations come to the conclusion that a matter of effectiveness of the legal instruments is effective or, for reasons of efficiency or other considerations, better be handled by the Consumer and Market Authority or by the Consumer and Market Authority and the Care Authority.
The Care Authority will follow the State Government ' s assessment of public health about the quality of the action of health care providers.
The care authority:
a. gives information about the content of its rules, policy rules, decisions and decisions and generally on the performance of its tasks;
b. makes all relevant information about rules, policy rules, decisions and decisions available on the Internet, relevant to its opinion;
c. lays down its rules, policy rules, decisions and decisions for each of them.
2 The health authority shall communicate in the Official Gazette, indicating that it is available to it, from:
(a) the adoption of rules by the placing of those rules;
b. the adoption of policy rules as referred to in Article 57 ;
(c) decisions relating to significant market power, specifying the obligation imposed and the duration of the obligation;
d. Decisions relating to tariffs and performance descriptions.
3 The first and second paragraphs shall not apply to decisions and decisions of the care authority to implement Chapter 6 .
1 The care authority shall report to our Minister on the feasibility, effectiveness and effectiveness of any proposed policy in relation to the exercise of its tasks, mentioned in the Article 16 .
2 The care authority is asked to ask and unsolicits to our Minister to take real developments in the field of care.
3 The reporting and alerts do not contain any medical personal data as intended Article 60 .
1 Our Minister, at the request of the care authority, shall provide the information and information necessary for the performance of its task.
2 Our Minister and the health authority jointly establish an information document. The information document contains substantive and procedural arrangements with regard to the provision of information, referred to in paragraph 1 and in Article 20 of the Framework Law on independent administrative bodies .
3 The information and information referred to in the first paragraph and in Article 20 of the Framework Law on independent administrative bodies , do not control medical personal data as intended Article 60 .
1 Care providers and health insurance companies provide for their regulations and conditions in the possibility of complaining about forms used by parties.
2 The complaint shall be made to the care authority. Rules and conditions should contain a provision that makes statements by the care authority the care providers, health insurance providers and consumers extend to binding advice.
3 The binding opinion shall be given upon receipt of the complaint and may provide that the form is:
a. is redundant or too complex and need not be filled in;
b. is complicated and will be evaluated a next time as a form referred to in subparagraph (a) if it has not been modified within two weeks of the opinion;
(c) does not give rise to grounds for stating the evidence based on the complaint.
1 The care authority will send to our Minister and the Zorginstitute a consolidated report on the legality of the implementation of the regulation before 1 November. Health insurance law and the regulatory regime based on it by health insurers and CAK in the previous calendar year.
2 Our Minister shall send the report to both Chambers of the States-General.
3 The health authority makes the report widely available.
4 The content and layout of the report may be subject to rules on the basis of a ministerial arrangement.
1 The care authority shall, without prejudice to its competence to carry out its own research, in the performance of its tasks, named in Article 16 (b) and (c) , as far as possible, use of the results of controls carried out by others.
2 The health insurers and the CAK provide the care authority with information on the activities carried out of those who are in charge of the control and inform it fully of the results of the audit by the production of reports or any other manner to be given by the care authority.
1 The care authority shall, at the request of Our Minister, investigate the matter with health insurers or the CAK.
2 The care authority may also set up research at the care insurers or the CAK at the request of the Zorginstitute.
The care authority may lay down rules on:
a. the control by health insurers, and in so far as they relate to the execution of what is determined by or under Article 118a of the Zorginsurance Act , by the CAK;
b. the content and establishment of the audit report, as referred to in Article 38 of the Zorginsurance Act And the research on which the report is based.
1 The care authority will send to our Minister and the Zorginstitute a consolidated report on the legality and effectiveness of the implementation of the programme before 1 December. Long-term care law and the regulations based thereon by the Wlz execs and the CAK, in the previous calendar year.
2 Our Minister shall send the report to both Chambers of the States-General.
3 The health authority makes the report widely available.
4 The content and layout of the report may be subject to rules on the basis of a ministerial arrangement.
1 The care authority shall, without prejudice to its competence to carry out its own research, in the performance of its task, named in Article 16 (d) , as far as possible, use of the results of controls carried out by others.
2 The Wlz execs and the CAK shall, upon request, provide the care authority with the information relating to the activities of those who are in charge of the control and shall inform it fully of the results of the audit by the production of: reports or any other manner to be given by the care authority.
1 The care authority shall, at the request of our Minister, investigate the situation of Wlz-execs and the CAK.
2 The care authority may also, at the request of the Zorginstitute, investigate investigations at the Wlz implementers or the CAK.
The care authority may lay down rules on:
a. the control by the Wlz performers and, insofar as it relates to the implementation of the Article 6.1.2 of the Act for long-term care tasks referred to, by the CAK,
b. the manner in which a Wlz exporter who is also a care office as intended Article 1.1.1 of the Act for long-term His financial report is intended to be Article 4.3.1 of that Act or its implementation report, referred to in Article 4.3.2 of that Act , inset,
c. the content and establishment of the declaration and of the audit report, as referred to in Article 4.3.1 of the Act for long-term care .
1 The care authority shall examine, taking into account: Article 65 , competition conditions and market behaviour in the field of care.
2 The investigation may, inter alia, focus on:
(a) the establishment of agreements in respect of care, tariffs or health insurance, according to the conditions set out in those agreements and the results thereof;
b. market functioning in the care, healthcare and health insurance markets;
c. the provision of information by healthcare providers and health insurance providers to consumers and the effectiveness, accuracy, understanding and comparability of that information;
d. the performance of health care providers and health insurance providers, including for the purpose of their comparison;
e. the underpinnings and development of costs and prices, including in relation to quality, of health care and health insurance.
The care authority may conduct its findings on the basis of the investigation, Article 32 , make public, with the exception of data and intelligence which, by their nature, are confidential.
1 A procedure that a health insurer or a healthcare provider applies as a condition of providing services or care to another healthcare provider or to a consumer may only require information that is of direct interest to the health care provider. the subject matter to which that procedure relates.
2 In the event of a change of health insurer, all proceedings relating to the insured person concerned shall remain valid.
The care authority may lay down rules on:
(a) operations for which no procedure may be imposed;
(b) the validity of the same procedure for a number of acts;
(c) the uniform application of procedures, where it may be prescribed that they are applied only by electronic means.
1 It is prohibited from a healthcare provider to charge a fee:
a. which does not correspond to the rate applicable to the performance in question on the basis of Article 50, first paragraph, part b , it has been established;
b. which is not within the tariff area which is based on Article 50, first paragraph, part c , the performance in question has been established;
c. for a performance for which no performance description based on Article 50, first paragraph, part d , it has been established;
d. For a performance for which a different performance description is used than on the basis of Article 50, first paragraph, part d , it has been established;
e. other than in the manner established in accordance with this Act.
2 A healthcare provider is prohibited from paying a tariff as referred to in the first paragraph, to any other healthcare provider or to reimburse to third parties.
3 It shall be prohibited to pay or to reimburse to third parties a fee as referred to in the first paragraph.
4 A healthcare provider and a health insurance provider may offer, agree or deliver a performance as referred to in paragraph 1 (c) or (d), or pay or pay to a third party of a fee as a result of: provided for in paragraph 1, do not grant any rights.
5 The third and fourth paragraphs shall apply mutatis mutandis to an insurer within the meaning of the Law on financial supervision , if not included in Article 1 (f) (3) -From this law.
6 If the care authority has established a rule as intended to Article 37, first paragraph , a healthcare provider as referred to in the fourth paragraph of that article, which receives the payments from charges levied, shall be prohibited:
a. To be transferred more than the amount determined by or under this Act;
(b) to deviate from the conditions, rules and restrictions laid down by that rule.
7 If the care authority when establishing a tariff as referred to in Article 50, first paragraph, parts a, b or c , according to the second paragraph of that article, it has been established to prohibit a healthcare provider from:
a. To derogate from the sum of the tariffs for the performance concerned, by the period specified for that period;
(b) to deviate from the rules or restrictions attached to the border.
It is a healthcare provider prohibited from an amount as intended Article 56a to be charged:
a. That is higher than the amount that would contribute to the availability of the relevant care based on Article 56a, first paragraph , it has been established;
b. other than in the manner established in accordance with this Act.
It is a health insurer prohibited from an amount as referred to in Article 56b to be charged:
a. That is higher than the amount corresponding to the liquidation concerned on the basis of: Article 56b, first paragraph , it has been established;
b. other than in the manner established in accordance with this Act.
1 Care providers and health insurance providers shall conduct an administration which shall, in any event, show the agreed and delivered benefits, and when those benefits have been delivered, to which particular patient to whom the insured person is performance by a healthcare provider has been delivered, the charges levied for that, and the related payments or fees to third parties received or made in connection with that.
2 Care providers and health insurance providers shall conduct an administration in such a manner that at any time is possible any tariff which is required to be paid in accordance with Article 50 or 52 has been established whether that is within the tariff area established, to be charged, to be paid or to reimburse to third parties under Article 50 (1) of the first paragraph.
3 The care authority may, with a view to the comparability of data, apply uniform principles in the allocation of costs and revenues, and in recording data on quality and revenue, lay down detailed rules on the application of the rules for the application of the rules for the application of the rules of procedure. the administration of:
a. Care providers and health insurance providers with a view to promoting competition, preventing fraud, the insightfulness and accessibility of that administration as well as the setting of tariffs; and
b. Health insurers and Wlz performers with a view to promoting proper execution of the Health insurance law Other Long-term care law .
4 The rules referred to in paragraph 3 shall be made in respect of health insurers and Wlz performers in accordance with the ZorgInstitute.
1 The care authority may lay down rules in accordance with which manner and under what conditions or subject to the rules and restrictions:
a. to whom, by whom, on behalf of who or through whom a tariff is charged;
b. to whom or to whom a charge may be paid;
c. who, by whom or on whose behalf any revenue for a tariff charged must be withheld, devolve on or transferred;
d. by whom or on whose behalf an amount to be determined by the care authority of not more than the overrun on the ground of Article 50, second paragraph, parts a, c or d , limit fixed, shall be retained and removed.
2 If the care authority adopts a rule as referred to in the first paragraph, introductory wording and point (a) for a performance jointly delivered by two or more care providers, it may, in that rule, determine that only one thereof designated healthcare provider a rate for that performance to be charged to the consumer or its health insurer, with the other healthcare providers involved in that performance exclusively to the designated care provider for the part of that can be charged a fee that has been delivered by them.
3 If the care authority establishes a rule as referred to in the first paragraph, introductory sentence and point (a) for a performance jointly delivered by two or more care providers, it may, in that rule, determine that the performance of the care care providers the rate for their share of that performance through the healthcare provider designated by it or a third party charge to the consumer or its health insurance provider, and that in doing so, the designated care provider or third party is the rate on a In such a way, account shall be taken of which part of the account to be sent is clearly expressed concern the part of the performance that has been carried out by the former healthcare providers.
4 If the care authority in a rule referred to in the first paragraph, introductory sentence and under a and b, for a performance jointly delivered by two or more health care providers, determines that a charged rate to or through one in that rule Designated care provider or third, further recipient, should be paid, this recipient ensures that the receipts for the fees charged by the other health care providers are withheld and are paid to them only. transferred if and to the extent that a payment is received from the consumer or his health insurer.
If the recipient is also designated on the basis of Article 37, first paragraph, introductory wording and point (d) , shall it ensure that the revenue for the tariffs charged by other health care providers is transferred only in compliance with that fee or the total of fees for any of the charges. other healthcare providers or all other health care providers jointly by or under this Act is determined.
5 Where and to the extent that the care authority, in a rule referred to in the first paragraph, introductory wording and point (b), determines who or through whom a tariff is to be paid, the consumer or his health insurance provider shall be that payment only to be payable to it.
6 The care authority does not apply the second and third members than after a designation by Our Minister on the grounds of Article 7 . Article 8 shall apply mutatis mutandis.
7 For the purpose of further implementation of the Act, a care provider shall be understood to include any person who receives, implies, departs or transfers the revenue from charging fees.
8 The provisions of or pursuant to this Article shall also apply in respect of any person who conducts an administration before a healthcare provider, and also in respect of the person carrying an administration for the purposes of, or in connection with, the taking into account of the the payment of or payment of a tariff, the receipt, content, issue or transfer of revenue for a tariff charged or the holding, surrender or transfer of an amount to be determined by the care authority in relation to the crossing of a fee by the care authority on the basis of Article 50, second paragraph, parts a, c or d -, fixed border.
9 The preceding paragraphs shall apply mutatis mutandis to the placing in charge or payment of a tariff for any part of a performance or a set of performance.
1 Care providers inform their patients in a timely and careful way about the rate of performance to be charged.
2 Care providers shall charge a fee, indicating the performance description associated with it.
3 The care authority may lay down detailed rules regarding it by healthcare providers:
a. publication of tariffs;
b. Specify accounts related to performance performance.
4 Care providers disclose information about the properties of offered performance and services, in such a way that such data is easily comparable for consumers. This information shall cover at least the rates and the quality of the performance and services offered.
5 The care authority may, without prejudice to the information obligation imposed on healthcare providers under the fourth paragraph, publish periodic information as referred to in the fourth paragraph for the purpose of market invisibility.
6 The fifth paragraph shall not apply if others already provide sufficient information to the disclosure of the information provided therein.
7 The care authority may lay down rules governing the provision of information referred to in paragraph 4 with a view to the effectiveness, accuracy, visibility and comparability of such information.
1 Care providers shall ensure that any information provided or made available on their behalf of a product or service, including advertising, does not affect or affect the particular information provided by or under this Act. Health insurance law or the Long-term care law And it's not deceptive.
2 The care authority may lay down rules governing the provision of information referred to in paragraph 1 with a view to the effectiveness, accuracy, visibility and comparability of such information.
3 The rules referred to in paragraph 2 shall be made in accordance with the State Supervision of Public Health.
1 Sickness Insurers disclose information about the properties of products and services offered in such a way that such data is easily comparable for consumers. This information shall cover, in any event, the premiums and the quality of the products and services offered.
2 Care insurers make public health insurance market information for the purpose of the insightability, for insurance companies, in relation to:
a. the content of the model agreements;
b. The mode of service to insured persons.
3 Health insurers shall ensure that information provided or made available on their behalf in respect of a product or service, including advertising, is without prejudice to or under this Act, or Health insurance law or the Long-term care law And it's not deceptive.
4 Article 38, fifth to seventh paragraphs , with regard to the provision of information by health insurance providers, shall apply mutatis mutandis.
1 In this article and in the Articles 42 and 43 The following definitions apply:
a. Distance agreement: an insurance contract relating to the risk of sickness costs between a health insurer and a consumer, concluded as part of a system of sale organised by the health insurer (i) distance, where the use of one or more techniques of remote communication is only used up to and including the conclusion of that agreement;
b. technique for remote communication: any means that, without simultaneous physical presence of health insurance provider and consumer, may be used to conclude an insurance contract relating to the risk of health insurance. between those parties.
2 An insured person may not be owed a contract at a distance without a fine and shall dissolve without giving reasons, for a period of 14 calendar days from the date on which the contract was entered into or, whichever is the later, during the period of the fourteen calendar days from the day on which the information provided by the health insurance provider Article 43, second paragraph , to be provided, received by him.
3 If an insured person wishes to make use of the right provided for in paragraph 2, he shall, before the expiry of the period referred to in paragraph 2, give notice to the health insurer in accordance with the instructions for the exercise of that right, which is the one that Article 43, second paragraph They've been given. The notification shall be deemed to be timely if it has been sent in writing or on a durable medium available to the recipient before the expiry of the time limit.
4 If a distance contract is otherwise connected with respect to a case or service delivered by the health insurer or by a third party under an agreement between the health insurance provider and this institution. third, the dissolution of the distance contract in accordance with the second paragraph shall be automatic and without the insured having due a fine, the dissolution of that contract.
1 The execution of a distance contract shall not be started until after the insured person has been authorised.
2 If the insured person makes use of his Article 41, second paragraph , under the terms of the law, the health insurer may only ask for a fee for the product or service provided under the distance contract. This fee shall be:
a. Not higher than an amount proportional to the ratio of the product or service already provided and the full implementation of the distance contract; and
b. in no case so high that it can be construed as a fine.
3 The health insurer may require payment of the allowance provided for in paragraph 2 only if:
a. can demonstrate that the insured person is in accordance with the provisions of the Article 43, second paragraph , has been informed of the compensation referred to in the second paragraph; and
b. upon the explicit request of the insured with the execution of the contract has commenced before the expiry of the Article 41, second or third paragraph , mentioned unbinding period.
4 The health insurance provider shall pay the consumer as soon as possible and at the latest within 30 calendar days of being notified of the Article 41 has received a cancellation as referred to in the second paragraph, having received his or her return from his or her distance from him.
5 The consumer releases the health insurance provider without delay, and at the latest within 30 calendar days of being notified of the Article 41 has dispatched decomposition, return all cases which he has received from the health insurer.
1 Of what is at or under the Articles 41 and 42 is determined, cannot be deviated to the detriment of the insured person.
2 With regard to the provision of information by health insurance providers in respect of the distance contract, it is appropriate to make provision for the provision of information on the provision of information and Articles 31, 1st paragraph In conjunction with 100 , 31, second paragraph , and 35 of the Financial Services Act applicable.
The provisions of or under the Articles 36 and 38 to 43 shall also apply in respect of the person who carries out an administration for a healthcare provider or health insurer, and of the person carrying out an administration for the purposes of, or in connection with, the offering, to charge, pay or reimburse to third parties a performance or tariff or receive a payment.
The care authority may, with a view to ensuring the visibility of the care markets, promote the competition or the timely alert of risks to the continuity of forms of care designated by the general measure of management, as appropriate Intended in Article 56a, first paragraph , lay down rules on arrangements for the establishment of agreements with regard to care or tariffs and on the terms and conditions of those agreements.
The care authority may, when establishing a rule under this law, determine that agreements shall be void in violation of that rule if and to the extent that they are not adapted within a period of time to be set by the care authority.
In the Articles 48 and 49 'significant market power' means the position of one or more healthcare providers or health insurance providers either to be able to jointly develop effective competition on the Dutch market or part of it Impede the ability to behave in an important degree independently of:
a. its competitors;
b. Health insurance providers, if they are a healthcare provider;
c. healthcare providers, if it is a healthcare provider;
d. healthcare providers, if they are a health insurance provider, or
e. consumers.
1 If the care authority considers that one or more health care providers or one or more health insurance providers only have significant market power at their disposal alone or jointly by the healthcare authority, according to the principles of general competition law, the care authority may impose one or more of the following obligations on a healthcare provider or healthcare provider or health insurance provider:
a. the obligation to identify categories of information to be determined by the care authority by the care authority, to be known by the care authority, in a manner to be determined by the care authority;
(b) the obligation to treat the customers of such services equally in equal cases when delivery of services to be determined by the care authority;
(c) the obligation to release a service to be determined by the care authority from other services;
d. the obligation to separate the costs and proceeds of services to be determined by the care authority which the healthcare provider or health insurance provider offers to itself or to its customers, from those of the other services provided by the health care provider; or activities carried out in the health insurance sector, and to do so, in accordance with the instructions given by the care authority;
e. the obligation to meet, under reasonable conditions, any reasonable request from a healthcare provider or health insurer to the conclusion of an agreement on or for the benefit of the care purchasing market;
f. the obligation for a health insurance provider to agree in its agreements with healthcare providers that it does not have an unreasonably high capacity in relation to the capacity that the insurer is expected to require for its insured persons;
g. the obligation to provide and maintain a public offering for the co-use of categories of care, services or facilities to be designated by the care authority;
(h) the obligation to modify the public offer referred to in point (g) in accordance with directions given by the care authority;
Obligation to determine the rates of services or supplies to be designated by the care authority in accordance with the method of calculation to be determined by the care authority;
(j) the obligation to use, for the purposes of the determination, as referred to under (i), a cost accounting system that meets the requirements of the care authority to determine the requirements of the care;
k. the obligation to establish, by means of a certificate of auditors or otherwise, on a single or periodic basis, by the care authority, whether the obligation referred to in point (i) and (j) is fulfilled;
l. the obligation for a healthcare provider to agree not to an unreasonably high capacity in its agreements with other healthcare providers in relation to the capacity that the former healthcare provider is expected to require for its consumers has;
m. Other obligations designated under ministerial arrangement.
2 Section 3.4 of the General Administrative Law Act shall apply.
3 The health authority shall comply with the requirements of proportionality when imposing obligations laid down in the first paragraph.
4 The care authority may commit to the obligations laid down in the first paragraph, rules and restrictions necessary for the proper execution of the obligations.
5 An obligation referred to in paragraph 1 shall cover a period of no more than three years from the date of entry into force of this paragraph. The care authority may decide to revoke within that period if the obligation to its judgment is no longer necessary. In addition, within that period, the care authority may decide to amend or renew the obligation each time for a period of no more than three years.
1 If the care authority has a reasonable suspicion that it is a judgment as referred to in the first member of Article 48 In urgent cases, it may prejudge the application of that article and the relevant healthcare provider (s) or health insurance provider (s) or health insurance provider (s) to impose one or more of the obligations, mentioned above. in the First paragraph of Article 48 .
2 Article 48, third and fourth members , mutatis mutandis, shall apply to the obligation referred to in the first paragraph.
3 Article 48, fifth paragraph The obligation shall apply mutatis mutandis to the obligation referred to in paragraph 1, except that the obligation shall be valid for a period of not more than six months and that it may be carried out once for a period of up to six months. extended.
1 It is a healthcare provider as intended in Article 1 (c) (1) , prohibit a concentration as defined in the Competition law to be established, without prior approval of the care authority.
2 An application for obtaining the approval is submitted by the care provider or, in case it is more than one healthcare provider, the health care providers jointly.
3 The prohibition referred to in paragraph 1 shall not apply to a healthcare provider who, as a rule, provides care to be provided by less than 50 persons.
1 The application, for the purpose of Article 49a, second paragraph , shall be accompanied by a report on the expected effects of the proposed concentration.
2 The report provides at least an insight into:
a. the objectives of the concentration;
b. the grounds for concentration;
c. the structure of the intended organisation of the healthcare provider or healthcare providers;
d. the financial impact of the concentration on the healthcare provider or healthcare providers;
e. the impact of the concentration on the provision of care to the client;
f. the risks of the concentration for the quality and accessibility of the care and the manner in which these risks are underused;
g. the judgment and recommendations of clients, staff and other parties concerned about the intention to concentrate and the manner in which they have been able to make this known, as well as a substantiation for the manner in which the judgment or recommendations are weighted by the intention to concentrate;
h. the manner in which and the time frame within which the concentration will be realized.
3 In the case of ministerial arrangements, further requirements may be laid down in the content of the report.
1 The care authority decides within four weeks on an application as intended Article 49a, second paragraph .
2 The care authority shall grant approval to the concentration if:
a. clients, staff and other persons concerned are not involved in a diligent manner in the preparation of the concentration, at least in a timely and understandable way to inform them of the contents of the concentration plans and the manner in which judgments or recommendations may be made known thereon;
b. the judgment and recommendations of clients, staff and other parties concerned are inconclusive and have been taken into account in the decision-making to concentration;
c. as a result of the concentration the continuity of forms of care designated by general measure of management as referred to in Article 56a, first paragraph It's in danger.
d. the report referred to in Article 49b, first paragraph , does not provide sufficient insight into the expected effects of the proposed concentration on the basis of the requirements set out in Article 49b, second and third paragraphs.
3 The care authority may attach conditions, regulations or restrictions to the approval.
4 In case the care authority gives its approval to the concentration, it shall make the report as intended Article 49b public. Data required by Article 10 of the Public Administration do not qualify for distribution, shall not be made public.
5 The Health Care Authority gives the Competition Authority an insight into the impact that the concentration will have on affordability, accessibility and, according to the findings of State Oversight officials, for the quality of care.
1 The care authority may, if it has a reasonable suspicion that it will not withhold its approval, waive the requirement in cases of urgency, at the request of the person who made the application for obtaining the approval. Article 49a, first paragraph That is the ban.
2 The waiver may be granted under restrictions, and the waiver may be subject to conditions or regulations within four weeks of the granting of the waiver.
1 Our Minister shall fix for each calendar year the amount available in that calendar year for the provision of care as intended in the Articles 3.3.1 , 3.3.2 and 3.3.3 of the Act for long-term care .
2 For the purpose of fixing tariffs for care in kind as intended Article 50, first paragraph , and amounts as referred to in Article 56b , as well as for the provision of personal budgets within the meaning of the Long-term care law , the care authority shall allocate the amount referred to in paragraph 1 above to the regions referred to in the first paragraph. Article 4.2.4, second paragraph, of the latter law .
1 The care authority shall, taking into account the requirements of the Articles 51 to 56 and 59 May, in a decision to be valid for the purposes of the law, be charged with a tariff:
a. Whether there is a free tariff, which is a tariff on which Article 35, first paragraph, points (a) and (b) , not applicable;
b. Whether there is a fixed rate;
(c) whether there is an amount that can be charged at least or at most as a rate;
d. the description of the performance, part of the performance or set of performance associated with the tariff referred to in points (a), (b) and (c).
In applying the chapeau and parts b and c in the first sentence, the care authority shall determine the level of the tariff or the amount that can be charged as a tariff in that decision.
2 The care authority may, for the purpose of applying the first member of its own motion, determine the sum of the charges for the performance in question in relation to a period specified above, prior to that period, of:
a. A fixed border,
b. A lower limit,
c. An upper limit or
d. A band width limit.
For distinct parts of a performance or complete of performance as intended in Article 57, third paragraph , individual boundaries and border species, as referred to in the preceding sentence, may be established.
3 The care authority may attach to the establishment of a tariff, a performance description or a border as referred to in the preceding paragraphs or restrictions.
4 The fixing of a tariff or a performance description shall, in any event, contain, as appropriate, the subjects mentioned in: Article 54 .
The care authority is fit Article 50, first paragraph, part a , only of its own motion.
The care authority is fit Article 50, first paragraph, parts b and c , please add:
a. At the request of a healthcare provider and a health insurance provider, if they have agreed a tariff. The rate determined shall apply to all cases where the healthcare provider charges the fee to the health insurance provider or to the person who is insured for the performance to which the rate applies;
b. At the request of a healthcare provider or a health insurance provider, or of its own motion, if a negative decision is taken on a request made under subparagraph (a). The second sentence of subparagraph (a) shall apply mutatis mutandis to that rate;
c. upon application by a healthcare provider or a health insurance provider, if an agreement as referred to in subparagraph (a) does not come into being. In fixing the rate of duty, the care authority shall determine the cases where the rate applies;
d. upon application by a healthcare provider or of its own motion, for all cases where it is charged to a person who is not insured for the performance to which the rate applies to a health insurance provider. Restrictions may be imposed in respect of the circle of persons to whom the tariff may be validly charged;
e. of ex officio, if a policy rule as referred to in Article 57 that progress;
f. of its own motion, if the care authority in this regard is a border referred to in Article 50, second paragraph That's right.
The care authority is fit Article 50, first paragraph, part d , please add:
a. where the care authority makes use of the power on the basis of Article 37, second paragraph ;
b. in the cases specified in Article 52, parts (a) to (f) ;
c. upon application by a healthcare provider or a health insurance provider with regard to an achievement for which the care authority based on the provision of or under Article 2, second paragraph , Article 50, first paragraph, part a , or Article 58, fourth paragraph, part a , no rate need to be fixed.
1 An application as referred to in Article 52 contain a proposal for:
a. The rate to be charged;
b. the period for which the rate will apply.
2 An application as referred to in Article 53 contains a proposal for the performance description to be determined.
3 If the care authority has not established rules as intended Article 37, first paragraph, introductory wording and point (a) , the application is intended to be used in the Articles 52 and 53 In addition, a proposal for:
(a) the person to whom the tariff concerned is charged;
(b) the person by whom the tariff concerned is charged;
c. the manner in which the tariff in question is charged.
1 The care authority decides, having regard to: Article 4:84 of the General Administrative Law , in any case dismissive of an application as referred to in Article 52 :
a. if the proposals in the application are contrary to the provisions of the policy rules, intended in Article 57 ;
(b) if the application does not comply with the provisions of this paragraph or pursuant to this paragraph.
2 The care authority decides, having regard to Article 4:84 of the General Administrative Law , in any case dismissive of an application as referred to in Article 53 :
a. if the proposed performance description conflicts with the law or with the interest of public health;
(b) if the application does not comply with the provisions of this paragraph or pursuant to this paragraph.
(1) Before the care authority takes a decision on an application for the establishment of a tariff as referred to in Article 4 (2). Article 52, parts a or d , it shall inform the healthcare provider and health insurer concerned, if any of them have so requested, of the health insurance provider and the health insurer concerned.
2 The care authority shall notify its intention to make an application in good time to the persons concerned referred to in the first paragraph.
1 The care authority may award an availability contribution for the purpose of the availability of forms of care designated by general management of the Board of Management as referred to in Article 3 (1) of the EC Treaty. Article 1 (b) (1) , subject to conditions, rules and restrictions to be laid down. A healthcare provider may charge the availability contribution to the ZorgInstitution to be charged to the Zorginsurance Fund or to the Fund for long-term care. For an availability contribution only forms of concern are eligible for which the costs are not or are not wholly attributable to, or by means of tariffs to be charged to, individual charges under this Act. (i) health insurers or insured persons, or whose financing is to be used in a market-distorting manner or in a market-distorting manner, and which are not financed by any other means.
2 The health authority shall apply the first member:
a. at the request of a healthcare provider or a health insurance provider;
b. of its own motion, if a policy rule as referred to in Article 57 That goes.
3 The award under the first paragraph is without prejudice to the charges levied by the care provider.
4 An application for application of the first paragraph shall contain a proposal for:
a. The amount to be charged;
b. The person by whom the amount is charged.
5 The care authority may attach any rules or restrictions to the granting of the amount.
6 In the case of, or under general management, conditions, rules and restrictions to be laid down, the form of the care authority may be determined in the form of the availability contribution.
7 In the case of or under general management measure, or in what cases our Minister or the care authority may, subject to conditions, regulations or restrictions, designate healthcare providers to be charged with a Service of general economic interest as referred to in Article 106, second paragraph, of the Treaty on the Functioning of the European Union or a service of general interest as provided for in Protocol No 26 to the Treaty on the Functioning of the European Union.
1 The care authority may fix a settlement amount, being an amount that a health insurance provider can charge to a healthcare provider for the benefit of settling it for a performance or set of benefits. It shall include a period of time specified by the care authority.
2 The health authority shall apply the first member:
a. at the request of a health insurance provider or a healthcare provider;
b. of its own motion, if a policy rule as referred to in Article 57 That goes.
3 The determination under the first paragraph is without prejudice to the charges levied by the care provider.
4 An application for application of the first paragraph shall contain a proposal for:
a. The amount to be charged.
(b) the person to whom the amount is charged;
(c) the person by whom the amount is to be charged;
d. the manner in which the amount is charged.
5 The care authority may attach regulations or restrictions to the determination of the amount.
1 The care authority shall lay down policy rules regarding:
a. The exercise of the power to impose obligations on the basis of the Articles 48 and 49 ;
b. exercising the power to set rates on the basis of Article 50, first paragraph, part a, b and c ;
c. exercising the power to establish performance descriptions based on the Article 50, first paragraph, part d ;
d. exercise the power to establish a border on the basis of Article 50, second paragraph ;
(e) exercising the power to establish amounts as referred to in the Articles 56a and 56b .
2 The rules of policy referred to in points (b), (c) and (e) of paragraph 1 may include in any manner, including in writing or by electronic means, under which conditions or subject to which rules or restrictions an application as referred to in that Article Articles must be submitted. The restrictions may include that the application can only be made by a healthcare provider with a health insurance provider jointly or that an application must be made within a certain period of time.
3 The policy rules may include under what conditions or subject to which rules and restrictions for the various parts of an achievement or a set of benefits to be applied in that rule in specified policy rules are.
4 The policy rules may include that these apply only to institutions designated on the basis of Article 8 of the Law on Special Medical Operations .
1 If the care authority in a policy rule as intended in Article 57 include the possibility of an experiment, it shall take into account the provisions referred to in this Article.
2 In the policy rule, the care authority may include under what conditions or subject to which rules or restrictions specified in that policy rule may be waived from other policy rules referred to in that policy rule as referred to in Article 3 (1) of the Treaty. Article 57 , or, of the general binding rules that it has set, as stated in that policy rule.
3 The restrictions referred to in paragraph 2 may include the operation of the relevant policy rule limited to a given area, to a particular category or part of a category of healthcare providers, from health insurance providers; of patients or of performance, or to a limited number of healthcare providers, health insurance providers, patients or performance.
4 The policy rule may imply that under conditions laid down in that policy rule or with respect to rules or restrictions set out in that policy rule:
a. Article 35 does not apply to the rate for the performance involved in the experiment;
b. Article 35, first paragraph, points (c) and (d) , does not apply to the performance description of the performance involved in the experiment;
c. Article 12, first, second or third paragraph, of the Law on the Sea Insurance Act or Article 4.2.2 of the Act on long-term care does not apply to the rate for the performance involved in the experiment.
5 A policy rule as referred to in paragraph 1 shall determine the maximum duration of the experiment, which shall not exceed five years. The care authority may decide to release all or part of the effects of the experiment until the end of the accounting year following the accounting year in which the experiment ended.
6 The health authority evaluates the experiment in time and during its execution.
7 The health authority reports on the outcome of an experiment to our Minister in any case within three months of the end of the experiment.
The care authority does not make than after a designation of our Minister on the grounds of Article 7 (b) (b) , a policy rule in relation to:
a. applying Article 50, first paragraph, part a, b or c , where no such policy rule is in place for the performance concerned or for an involved category of healthcare providers in respect of the performance concerned;
b. to amend a policy rule regarding the establishment of a tariff as referred to in Article 50, first paragraph, part a, b or c , in the sense that the performance involved in that policy is to be covered by a different tariff type as specified in those parts;
c. establishing a border as referred to in Article 50, second paragraph ;
d. to amend a policy rule concerning the establishment of a limit as specified in the parts of Article 50, second paragraph , in the sense that the border mentioned in that policy rule is to be covered by another border species as referred to in those parts;
e. the fixing of an amount as referred to in Article 56a and 56b ;
f. an experiment as intended Article 58 .
1 In this chapter, personal data are distinguished in:
a. Personal data identifying information;
b. Medical personal data,
c. criminal personal data.
2 The identification of personal data shall mean:
a. Name, address, place of residence, postal address;
b. Date of birth and sex;
c. administrative data, such as bank, giro and credit card numbers, data from basic registration persons and registration pursuant to the Law on the professions in individual health care .
3 Under this law, under medical personal data means personal data relating to health as referred to in Article 3 (1) of the Treaty. Article 21 of the Personal Data Protection Act .
4 Under criminal personal data means personal data as referred to in Article 22 of the Personal Data Protection Act and personal data relating to unlawful or harmful conduct in relation to a prohibition on the basis of that conduct.
1 Each has been kept to the care authority or to any person designated by that person, upon request, further to be indicated in this Article as a matter of charge, free of charge and subject to the conditions of Article 65 :
provide the data and intelligence which may reasonably be relevant for the implementation of this Act;
(b) the books, documents and other data media or their content-on the choice of the applicant-for which the consultation may reasonably be of interest for the determination of the facts likely to affect the execution of the data; this law, to make available for this purpose.
2 In the event that this law considers matters of a third party as matters of the person subject to information subject to information, in so far as these matters are concerned, equal obligations for the third party shall apply.
3 The obligation referred to in paragraph 1 (b) shall apply without prejudice to any third party to whom the data media of the person concerned, or the content thereof, are to be made available to the applicant for consultation.
4 The applicant shall simultaneously inform the person whose data media he progrests to a third party for consultation.
5 The information and information must be given orally, orally, in writing or in any other way-to the choice of the applicant-and within a period to be set by the applicant, without reservation.
6 Copies of legible copies, legible printing or extracts shall be admitted, or their content, from the data media which are available for consultation.
7 The obligation of the first or second member shall not apply if the person concerned has already provided the requested information or information to another administrative body and may be supplied by that administrative body to the care authority.
1 The care authority may, subject to compliance with the provisions of Article 65 , lay down rules laying down which data and intelligence are to be provided regularly or under what circumstances they should be provided by healthcare providers, health insurance providers and those, intended Article 44 .
2 The first paragraph shall also apply in respect of the person collecting, storing and editing information for the benefit of healthcare providers or health insurance providers, as well as to the group within the meaning of Article 24b of Book 2 of the Civil Code , where healthcare providers or health insurance providers belong to it.
The information and information referred to in this Chapter shall be provided in full and in truth.
Data retrieval and information, intended to be used in the Articles 61 and 62 , is Section 5.2 of the General Administrative Law of corresponding application, with the exception of the Articles 5:11 , 5:12 and 5:20 .
Our Minister gives to ministerial regulations:
a. Which of the Article 60 separate categories of personal data are necessary for the exercise of the tasks and powers of the care authority designated under that scheme;
b. which of the Article 60 differentiated categories of personal data the care authority may provide to the in Article 70 the bodies referred to in respect of the exercise of their duties and powers.
1 Care providers and health insurance providers shall be obliged, on request, for their own identification and, subject to compliance with the provisions of this Regulation, Article 65 , the in Article 60 provide the health care authority and the FIOD-ECD with the identification of the identifying personal data and personal data referred to above, and the enforcement of the data Articles 35 , 36 and 38 , including the implementation of the Law on economic crimes .
2 Care providers and health insurance companies are not required to provide any medical personal data on request for the execution of an obligation imposed by the first member on others.
3 The first paragraph shall also apply to the person referred to in the Article 44 .
1 The person receiving information and information pursuant to this Act shall be subject to the same legal provisions concerning the confidentiality of such data and information as for the person who has supplied them.
2 The data and information provided for in Article 70, second paragraph , shall be provided by the care authority provided that:
(a) the confidentiality of the data or information has been sufficiently safeguisable; and
b. adequately ensured that the data or intelligence is not to be used for any purpose other than that for which it is provided.
3 The first paragraph shall be without prejudice to the powers of the Court of Auditors Article 91 of the Comptability Act 2001 . The Court of Auditors is the General Court of Auditors in the field of communications as referred to in Article 91, eleventh to fourteenth paragraph, of that Act compulsory confidentiality insofar as it concerns information and information which have become known to it by virtue of the first sentence.
1 The care authority may, subject to compliance with the provisions of Article 65 , lay down rules, including to whom data and intelligence are to be determined in the context of the Articles 61 and 62 , must be provided, the timing and manner in which and the form in which the data and information are to be provided or by whom and how the data is to be processed or by whom and the manner in which the data or the data is operations of that data are to be disclosed, as well as an auditor as referred to in Article 393 of Book 2 of the Civil Code to confirm the accuracy of the information and information provided.
2 The rules referred to in paragraph 1 may also include the manner in which the form or form in which data and intelligence, including personal data, are to be determined, including medical data, must be processed before the operation is to be made.
1 A care provider who has provided to an insured person, and who is directly charged by a contract concluded by him with the health insurer, shall provide such services directly to that health insurance provider health insurer, or a person designated by that health insurance provider, the personal data of the insured person, including personal data relating to health as referred to in the Personal data protection law , which are necessary for the implementation of either the health insurance or the law or, for that purpose, it shall make it available for inspection or the taking of copies.
2 A healthcare provider who has granted care to an insured person and charges them with the insured person shall provide him with the personal data, including personal data relating to his health as intended in the Personal data protection law , which are necessary for the implementation of health insurance or of the law for his health insurance provider.
3 Save as otherwise provided by any statutory provision, persons shall be employed by a health insurer, by a person designated by the health insurer or by a person designated by Our Minister, as referred to in Article 3 (2). Article 87 (3) of the Zorginsurance Act Persons who are not subject to professional secrecy by virtue of post or profession shall require the confidentiality of personal data of an insured person, including personal data relating to his or her health as referred to in the Personal data protection law , which are necessary for the implementation of health insurance for a health insurance provider.
4 By ministerial arrangement, the following may be determined:
a. to which information and to which category of health insurance providers as referred to in Article 1 (f), the obligation, referred to in the first or second paragraph, extends in any event;
b. to which data referred to in the first or second paragraph are processed;
c. according to which technical standards data processing takes place;
d. the security requirements for data processing;
e. in which cases data referred to in the first or second paragraph are further processed for the purposes of the implementation of medical expense insurance, provided that such data are not used for the purpose of assessing and accepting a prospective insured person by a health insurance provider as intended in Article 1 (f) (3) , and are also necessary for:
1. the payment to a healthcare provider or the reimbursement of care expenses to an insured person,
2 °. the determination of own contributions, outstanding own risk or a no-claim return to the insured person,
3 °, the exercise of the law of redress, or
4 °. to carry out checks or fraud investigations.
1 Without the obligation of health care providers and health insurance providers to provide data and intelligence as intended in the Articles 61 and 62 In the exercise of tasks entrusted to it, the care authority may use its own information if the information and information referred to in those articles is not, or is not, to be fully disclosed.
2 The care authority shall be empowered to use all the information and information it has collected on the basis of all its legal powers to this end for all the tasks assigned to it.
3 In case of use by the care authority of information, data and intelligence as referred to in the first and second member, the specific Article 65 with regard to the processing of personal data of corresponding application.
1 The care authority, the Zorginstitute, the College Building, the College remediation and the State Supervision of Public Health provide each other with data and information that may be relevant to the exercise of their legal tasks.
2 The Care Authority shall, on request, provide the Consumer and Market Authority, the Netherlands Bank, the Financial Markets Authority, the College protection personal data and the FIOD-ECD which may be of interest to the Authority. for the exercise of their legal duties.
3 The health care authority is providing the Health Council, the Rijksinstituut for Health and the Environment, the Health and Health Council, the Health Research Council, the Central Planning Bureau, the Central Bureau of Health Research and the Health Council. Statistics and the Social Cultural Planning Office to reduce the administrative burden on data and intelligence which may be relevant for the exercise of their legal tasks.
4 In the case of benefits in kind provided for in the first to third paragraphs, the provisions of Article 65 Eight.
5 The care authority shall not use its powers, as provided for in the first to third members, in the application of the first to third members. Articles 61 and 64 .
The Registrars or Secretaries of the Law of the judicial organisation said dishes, of the Central Board of Appeal, of the College van Beroep for business and of disciplinary colleges, intended in Article 47, third paragraph, of the Act on the professions in individual health care , submit to Our Minister, to the care authority, to the FIOD-ECD or to any Article 72 designated person free of all costs all data and extracts from or copies of judgments, judgments, judgments, registers, and other documents required for the execution of this Act.
1 With the supervision of compliance with or under this Act, the following shall be entrusted:
a. The officials designated by the decision of Our Minister;
b. The care authority's staff designated by decision of the care authority;
c. Public health officials of the State Supervision; and
d. The staff of the FIOD-ECD.
2 A decision as referred to in paragraph 1 (a) or (b) shall be communicated by the State Official Gazette.
Those who are Article 72 be entrusted with the supervision of and those who are responsible for compliance with Article 17 of the Law on Economic Crimes be responsible for the detection of what is established by or under this law as a criminal offence, shall provide each other with all the information and information necessary for the performance of their duties.
The Care Authority has a reporting point for receiving data and information on facts and circumstances that may not be in conformity with or under the law.
The care authority shall disclose in public the manner in which it intends to implement the tasks and powers conferred on it in this chapter.
1 The care authority is competent to maintain the provision of, or under the conditions of Article 23 , 25, second paragraph , 27 , 31 , 34 , 35 to 45 , 48 , 49 , 49a , 49c, third member , 49d, 2nd Member , 61 , 62 and 68 to give a designation to the effect that compliance with or under those Articles is fulfilled.
2 If the care authority provides a health care provider with a prompt to maintain Article 35, seventh paragraph , or Article 37, first paragraph, introductory wording and point (d) , the indication may, in so far as it concerns the amount of the amount to be paid, consist solely of the obligation that the care provider should fix an amount to be determined by the care authority of not more than the exceeding of the amount specified in those articles. carry the fixed limit, upper limit or tyre widens to the Zorginsurance Fund or the Fund for long-term care.
The care authority may, by virtue of its duty, be Article 16 (b) and (c) , give a lead to a health insurance provider, or to an insurer who provides or execs insurance as health insurance that does not comply with or under the Health insurance law Compliant.
1 The care authority may, by virtue of its duty, be Article 16 (d) , give a clue to a Wlz executor who, or the CAK that does not comply with or under the Long-term care law .
2 The care authority may, by virtue of its task, mean in Article 16 (f) , give a clue to the CAK if the CAK does not comply with what is at or under Article 118a of the Zorginsurance Act and Article 2.1.4 of the Social Support Act 2015 is arranged.
3 If a Wlz executor has outsourced work to other Wlz executor and a lead issued by the care authority pursuant to paragraph 1 with respect to the manner in which this task is carried out by the relevant person, has not led to a lawful and effective execution within the period referred to in the second paragraph, the care authority shall inform our Minister, indicating the name of the Wlz exporter which has been contracted to it.
The care authority may, by virtue of its duty, be Article 16 (g) , give a clue to a health care provider, be focused on compliance with it mentioned in that part Article 66d, second paragraph, of the Zorginsurance Act shall be satisfied.
1 The care authority does not give any indication as intended in the Articles 76 to 78a concerning the assessment or treatment of individual cases by the person to whom the designation is addressed.
2 At the time of designation, the care authority shall set a time limit within which the person concerned complies with the designation.
1 If a health insurer, an insurer referred to in Article 77 -CAK or a Wlz executor, hereinafter referred to as: the person concerned, not within the period specified in the Article 79, second paragraph , to a under Article 77 Other 78 given designation, the care authority shall be competent to:
a. to impose a burden under administrative coercion; or
b. To public knowledge, including, where appropriate, the considerations which led to that notification:
1 °. that the person provides or carries out insurance as a health insurance policy that does not comply with or under the Health insurance law regulated compliance;
2 °. that the health insurer or the Wlz executor is acting in violation of one or more reported by the care authority, at or under the Health insurance law or the Long-term care law regular provisions;
3 °, which has been given to the person concerned a designation or a charge under penalty payments or an administrative penalty has been imposed.
2 The care authority shall, if it intends to bring a fact to public notice, inform the person concerned of the grounds on which it is based.
3 By way of derogation from Article 4: 8 of the General Administrative Law Act the care authority is not required to give the person concerned the opportunity to express his views, if the person concerned is not aware of an address and cannot obtain the address with a reasonable effort.
4 In any event, the decision to bring a public notice to public knowledge shall state the fact that it is made available to public authorities and the manner and time of the procedure to which it is to be made.
5 The notification shall be made not earlier than after five working days have elapsed after the publication of the notice, referred to in paragraph 2, to the person concerned.
6 If the person requests a provisional provision as intended: Article 8:81 of the General Administrative Law the operation of the decision shall be suspended until a judgment has been given by the court of supply.
7 If the proper functioning of the insurance market or the position of the insurers on that market does not permit a deferral, the care authority may, by way of derogation from the second to sixth paragraph, inform without delay the fact.
8 If the person concerned complies with the designation after a publication as referred to in paragraph 1 (b), the care authority shall notify it in the same way as in the case of the prior publication.
1 If a health care provider or a health insurance provider, to the extent not in a case referred to in Article 80, first paragraph (hereinafter referred to as 'the person concerned'), not within the period specified in the Annex. Article 79 , to a under Article 76 given designation, the care authority shall be competent to:
a. to impose a burden under administrative force;
b. To public knowledge, including, where appropriate, the considerations which led to that notification:
1 °. that the person concerned acts in contraa with one or more of the provisions laid down by the care authority, by or under this Act;
2 °; which is either a designation or a penalty imposed on the person concerned or an administrative penalty has been imposed; or
c. the amount, intended to Article 76, second paragraph To be recovered. Title 4.4 of the General Law on administrative law shall apply mutatis mutandis.
2 If the adequate functioning of the health care or care procurement market or the position of care providers in that market does not permit a delay, the care authority may inform the public without delay.
3 Second to eighth members of Article 80 shall apply mutatis mutandis with regard to the first and second members.
1 If a healthcare provider does not enter within the period specified in Article 79, second paragraph , to a under Article 78a given designation, the care authority shall be competent to:
impose a burden under administrative coercion; or
to public knowledge, including, where appropriate, the considerations which led to the notification:
1 P. that the healthcare provider is acting in violation of Article 66d, second paragraph, of the Zorginsurance Act ;
2 P. which has been given an indication to the healthcare provider or a charge under penalty payment or administrative fine.
2 Article 80, second to sixth paragraph and paragraph 8 , shall apply mutatis mutandis.
3 If the adequate functioning of the care market or the position of care providers in that market does not permit a postponement, the care authority may, by derogation from the second member in conjunction with Article 80, second to sixth paragraphs , bringing the fact to public notice without delay.
The care authority is in order to maintain the provision at or under the Article 25, second paragraph , 31 , 35 to 45 , 48 , 49 , 49a , 49c, third member , 49d, 2nd Member , 61 , 62 , 68 , 68a or 79, second paragraph , responsible for the imposition of a burden under administrative coercion, or the imposition of a charge under penalty payments.
1 The care authority may impose a charge on a health insurer on the penalty of infringement of the rules laid down in or under the rules of Articles 3 , 4, second to fifth members , 5, third member , 9 , 25, third member , 28 , 29, first and second members , 35, second paragraph , 37 , 38, first and fourth members , 64, second member , 68, second paragraph , 86 , 87, fifth or sixth Member , 89, first, second and seventh members , 90 , 92 , 96, fifth paragraph , 114 or 118a, third member, of the Zorginsurance Act .
2 The care authority may impose a charge on an insurer or a legal person on the penalty payment in respect of infringement of the Articles 25, first and second members , respectively 30 of the Zorginsurance Act .
3 The care authority may be an insurer offering or executing insurance as health insurance that does not comply with it or under Health insurance law regulated compliance, impose a load on penalty payments.
The care authority may be an AWBZ insurer, CAK or a legal person as intended Article 40 of the General Health Insurance Act impose a penalty on the penalty on violation of the rules, set up by or pursuant to That Act or the Social insurance financing law .
The care authority may impose a charge on a healthcare provider on the penalty of violation of Article 66d, second paragraph, of the Zorginsurance Act .
1 The care authority may impose an administrative penalty on infringement of the specific case of, or under the conditions of Article 23 , 34 to 45 , 48, 1st Member , 49 , 49a , 49c, third member , 49d, 2nd Member , 61 , 62 or 68 .
2 The administrative penalty for a separate infringement shall not exceed € 500 000 or, if more, 10% of the turnover of the undertaking in the Netherlands.
3 The calculation of turnover referred to in paragraph 2 shall be calculated on the basis of Article 377, 6th paragraph, of Book 2 of the Civil Code determines the net turnover.
1 The care authority may impose an administrative penalty on a health insurer in respect of infringement of the specific case of, or under the control of Articles 3 , 25, third member , 28 , or 29, first and second member, of the ZorgInsurance Act .
2 The care authority may impose administrative penalties on an insurer or legal person in respect of infringement of the rules laid down in the Regulation. Articles 25, first and second members , or 30 of the Zorginsurance Act .
3 The administrative penalty for a separate offence shall not exceed € 500 000.
1 The care authority may impose an administrative fine on a health insurer providing the Zorginstitute or a person designated by him with incorrect or incomplete information in respect of the numbers insured with him insurance obligations, their insurance characteristics or their cost of care, necessary for the determination of the contributions, intended for the purposes of the Articles 32 to 34 of the Zorginsurance Act .
2 The administrative penalty for a separate infringement shall not exceed € 10 000 000.
1 The care authority may impose an administrative penalty on a health insurer in respect of infringement of the rules laid down in or under the conditions of Article 4, second to fifth paragraphs , 5, third member , 9 , 35, second paragraph , 37 , 38, first and fourth members , 64, second member , 68, second paragraph , 86 , 90 , 92 , 114 or 118a, third member, of the Zorginsurance Act .
2 The administrative penalty for a separate offence shall not exceed € 100 000.
1 The care authority may impose an administrative penalty on the person who does not comply with a person with or under Article 68a of this law, or Article 87, fifth or sixth paragraph , 88 or 89 of the Zorginsurance Act obligation imposed.
2 The administrative penalty for a separate offence shall not exceed € 2 250.
1 The care authority may impose an administrative penalty on a healthcare provider in respect of infringement of Article 66d, second paragraph, of the Zorginsurance Act .
2 Article 85, second and third paragraphs , shall apply mutatis mutandis.
1 The care authority carries it on the grounds of Article 81, first paragraph, part c , amount recovered from the Zorginsurance Fund or Fund long-term care.
2 The care authority bears the on-the- Articles 82 and 85 Fines recovered and administrative fines to be paid to the State's treasury.
3 The care authority bears the on-the- Articles 83 and 86 to 89 Fines recovered and administrative fines to be paid to the Zorginsurance Fund.
4 The care authority is carrying the Article 84 inadvanced periodic penalty payments to the Fund for long-term care.
5 The care authority bears the on-the- Articles 81a , 84a and 90 The ZorgInsurance Fund or the General Fund Special Sickness costs.
With regard to decisions in which consumers or patients may be interested, for the purposes of applying Article 8: 1 of the General Administrative Law Act , consumer and patient organisations active at national level identified as stakeholders.
By way of derogation from Article 45 of the Law of the Judiciary The court of Rotterdam is taking notice of criminal cases and economic crimes under this law.
By way of derogation from Article 4 can provide the care authority for four years, starting from the entry into force of Article 4 of this law, of not more than four members.
1 The Health care rates Act shall be withdrawn.
2 A rate which shall be taken into account, immediately before the date of entry into force of this Act, to health insurance companies or to those who are in it for the performance to which the rate applies. in all cases where it is charged to the person belonging to the same group or to a third party, it shall be considered to be a rate established under that law.
3 A due to the Health care rates Act a request for the approval or establishment of a tariff by a health or health insurance institution shall be treated in the same way as an application for the establishment of a tariff as provided for in this Act.
4 The second and third paragraphs shall apply mutatis mutandis to a performance description of a form of concern for which a tariff is charged.
5 A due to the Health care rates Act The policy rule adopted shall be treated as a policy rule adopted pursuant to this Act.
6 A due to the Health care rates Act the College rates health care law shall be treated as a rule established pursuant to this Act by the Care Authority.
7 A due to the Health care rates Act Adopted policy rule to whom, by whom and in what conditions and subject to which conditions, rules or restrictions a tariff is charged, shall be treated as a result of such a law by the care authority defined rule as specified in Article 37 .
8 A policy rule as referred to in Article 13 of the Health Care Rates Act such as that law was, immediately before the date of entry into force of this Law, equivalent to a designation as intended Article 7, first paragraph, introductory wording and point (b) .
1 The College rates health care, named in Article 18 of the Health Care Rates Act , and the College of Supervision of Health Care Insurance, named in Article 77, first paragraph, of the Zorginsurance Act , as those laws were enacted immediately before the date of entry into force of this Act, they together form one legal entity, and the health care authority. Decisions of the College of Health Care or the College of Health Care Supervision shall be considered to be decisions of the care authority after the entry into force of this Act.
2 The adoption by the care authority of a Board of Staff Regulations as referred to in Article 5 a "work programme" and a "budget" as referred to in Article 11 , as soon as possible, take place for the first time in respect of the calendar year following that in which this law was placed in the Official Journal.
3 Our Minister shall establish a provisional administrative regulation for the care authority. The provisional Regulation shall apply until the Management Rules of the care authority have obtained the approval of Our Minister.
4 As far as the first to third paragraphs do not provide, our Minister shall lay down rules on the consequences of the entry into force of this Act. Those rules shall apply until 31 December of the calendar year following that in which they entered into force. The setting of these rules shall be notified to the two Chambers of the States-General.
5 In so far as the rules referred to in the fourth paragraph refer to matters on which the care authority may lay down rules, they shall apply to those rules of the care authority.
6 By way of derogation from Article 6 of this law are the rules for officials appointed to ministries for a period of four years from the date on which the Importation and Adaptation Act Zorginsurance Act has entered into force, does not apply to the legal status of the staff of the care authority. During that period, the legal position of such staff shall be governed by the care authority.
7 With effect from the date of entry into force of this Act, the staff of the College rates health care and the College of Supervision of Health Care Insurance employed by the care authority. In doing so, their working conditions as a whole are set at an equal level to the conditions of employment associated with their employment in the College of health services, and the College of Supervision of the the health insurance. Rules governing the provisions of this paragraph may be laid down by Ministerial Regulations.
Before 1 January 2009, our Minister shall send a report to the States General on the effectiveness and effects of this law in practice. In any case, attention shall be paid to:
a. the way the decisions of the care authority have contributed to the achievement of the purpose of the law;
(b) the determination of the significant market power;
c. the extent to which the law has contributed to the reduction of bureaucracy;
d. the effectiveness and desirability of tariff regulation;
e. the tasks relating to competition law.
The articles of this Law shall enter into force on a date to be determined by royal decree, which may be determined differently for the various articles or parts of such articles.
This law is cited as: Health organization health care law.
Burdens and orders that it will be placed in the Official Gazette, and that all ministries, authorities, colleges and officials who so concern will keep their hands on the precise execution.
Given at The Hague, 7 July 2006
Beatrix
The Minister for Health, Welfare and Sport
,J. F. Hoogervorst
Issued the twenty-first September 2006The Minister of Justice
J. P. H. Donner
