The Dutch Healthcare Authority (NZa) has already received dozens of reports this year about healthcare providers asking their patients for a surcharge. The healthcare providers do this because they do not consider the rates they receive from health insurers to be high enough. The reports are being investigated because asking for a voluntary personal contribution per treatment is not permitted.
The reports come from mental health care and from the physiotherapy sector. “It usually concerns small amounts from one euro to about ten euros. People are often asked to pay in cash,” says Tsui Ying Leung, press officer at the NZa.
Costs for rent or energy
“They often say they can’t pay the cost of the rent or the utility bill and then ask for a contribution from the patient,” she explains. In recent months, she has seen a sharp increase in the number of reports of this type of personal contribution.
Healthcare providers are not allowed to ask for extra money for rent, energy costs and personnel costs. These matters are already included in the rate that they are allowed to charge.
‘It’s just not allowed’
Minister Kuipers says in a response that the relevant healthcare providers are in violation. “I can come up with all kinds of reasons why they do it, but it’s just not allowed,” he says. Kuipers believes that the NZa and the insurers should have discussions with these healthcare providers.
The minister advises patients not to use a debit card or to pay for the ‘surcharge’ at a healthcare provider. Patients can report online that healthcare providers ask them for a personal contribution.
The reports are being investigated by the NZa. This may lead to the NZa taking formal measures. “This can be done through an indication, which is a kind of warning. We can also impose a fine, but we hope that the research will stop providers from doing this sooner. We don’t want the patient to have to pay for this,” says Ying Leung.
Minister Kuipers wants to wait for the investigation before possibly imposing sanctions.
The branch association of physiotherapists KNGF has been aware of the reports for some time. “We do not support the fact that extra costs will be charged, but we can imagine that it will happen because of the far too low rates that health insurers offer,” says a spokesperson. He emphatically adds that it is really not allowed: “It shouldn’t be like that.”
According to him, research by the KNGF in collaboration with health insurers already showed in 2019 that the rates of health insurers are below the cost price: “At that time, physiotherapy was 20 percent lower. to cover their costs.”
According to the KNGF, health insurers should increase their rates. “Because health insurers now offer rates that are too low and healthcare providers are going to charge these kinds of costs, policyholders are the victims.”