Directors of healthcare facilities with a criminal record or a dubious past can still start a new youth- or home care agency. The new legislation created at the beginning of this year should tackle this problem. However, experts do not consider the legislation adequate, as stated in an article by RTL Nieuws. André den Exter, Associate Professor of Health Law at Erasmus School of Law, is one of them; “honestly, I dare to say you can call it symbolic legislation”.
“Healthcare fraud is a massive social problem”, states Den Exter in the Nederlands Dagblad. “In the long-term healthcare sector alone, fraud amounted to approximately 35 million euros in 2019.” Moreover, the healthcare sector is frequently used to launder money or exploit vulnerable clients. The newly created law had to put a stop to these malicious practices. However, experts like Den Exter are sceptic and do not expect this law to change anything.
Loopholes in the new law
The Law on the Accession of Healthcare Providers obliges every new health care facility to report this to the Ministry of Health, Wellbeing and Sports (VWS). The VWS can ask for a Statement of Conduct or start additional integrity research into the criminal past of a new director. In the first two months of 2022, 1270 new health care companies were started. Nonetheless, 1250 of those 1270 are excluded from this check as it excludes small companies with less than ten employees. This way, directors of healthcare facilities with a dubious past can slip through the loopholes of the law and keep starting new companies without being checked.
Risky exception
“The risks are higher with these small companies”, Den Exter states. “Earning revenue is the main goal, and these companies do not always have the right qualifications. So, you do not want them to operate in the health sector. However, they are allowed to since they are excluded in the law”, concludes the Associate Professor. “Honestly, I dare to say you can call it symbolic legislation”, Den Exter states.
How should it be done?
According to experts, a reduction of malicious health care companies can be achieved by better inspection, both on paper and physically. Additionally, municipalities should also provide an examination. They are the counterparties to contracts with health care companies. Therefore, they should critically assess which companies they want to do business with. The Association of Dutch Municipalities (VNG) agrees but states that it does not have the possibilities nor the means to do so.
Additionally, Den Exter states that health insurers have a significant duty to reduce health care fraud. By performing materialistic checks, they can discover whether health care companies did indeed perform the claimed care. Den Exter claims that medical disciplinary law can offer a solution in case of declaration fraud. “The disciplinary judge is unpersuadable for crooks and fraudsters. Committing fraud violates professional core values like reliability, carefulness and social responsibility.”
