Dutch cabinet continues talks to save provider network bill

Health insurers in the Netherlands can now sell indemnity policies that let enrollees see any provider who is willing to accept the Dutch equivalent of a reasonable and customary fee. Dutch companies can also sell “natura” plans, or health care services agreement plans, that give enrollees access to the providers who have agreed to participate in the plan provider network.

Under current Dutch laws based on a European insurance law framework, the health care services plan managers can impose penalties on enrollees who get out-of-network care, but not penalties high enough to create an obstacle to use of care. Dutch authorities have held that health care service plans must pay 75 percent of the cost of out-of-network care.

The proposal now being debated would let an insurer choose its own level of reimbursement for out-of-network care, or decline to pay for out-of-network specialist care. Enrollees would still have a right to get full compensation for out-of-network specialist care if the plan failed to provide the necessary care within a reasonable distance and a reasonable period of time, according to Edith Schippers, the Dutch health minister. 

Supporters argue the proposal would help hold down the cost of care. Critics say it could interfere with patients’ access to care.