THE BOTTOM LINE
- New, lower government-set tariffs for Dutch dental and orthodontic care for 2026 will proceed as planned, despite a legal challenge. Orthodontic practices face an average rate reduction of 11.18%, while dental practices will see a smaller 1.12% cut.
- The court affirmed the Dutch Healthcare Authority (NZa) has significant discretion in its tariff-setting methodology. This includes the right to exclude business costs like goodwill and to use weighted averages that may favor larger, more efficient practices.
- Although the tariffs were upheld, the court identified a serious transparency flaw in the regulator’s labor cost calculations. This signals increased judicial scrutiny and provides a clear path for future challenges against regulated pricing models.
THE DETAILS
This case concerned an emergency injunction sought by the Royal Dutch Dental Association (KNMT) and other professional bodies against new maximum tariffs set by the Dutch Healthcare Authority (NZa) for 2026. The associations argued that the NZa’s underlying cost-price study was flawed and the resulting tariffs were not economically viable, threatening the continuity of care. The legal challenge focused on two main areas: the exclusion of goodwill amortization as a reimbursable cost and the NZa’s use of a weighted average for practice costs, which the associations claimed unfairly disadvantages smaller practices.
The Trade and Industry Appeals Tribunal (College van Beroep voor het bedrijfsleven) sided with the regulator on these core methodological points. The court ruled that the NZa acted within its broad discretion by defining goodwill as a cost related to business acquisition rather than a direct cost of providing care. Similarly, the court accepted the NZa’s reasoning that using a weighted average for practice costs—giving more weight to larger practices—was a reasonable method to calculate a national average cost without overcompensating the entire sector. This reaffirms the high bar required to successfully challenge the technical economic models used by market regulators.
However, the ruling was not a complete victory for the NZa. The court found a significant motivation defect in the NZa’s calculation of the normative annual cost (NAC) of a practitioner’s labor. Echoing a recent landmark decision concerning general practitioners, the court found the underlying consultancy report to be a black box, failing to transparently show how it weighed various job components to arrive at a final salary figure. Despite this serious flaw, the court performed a balancing of interests and ultimately declined to suspend the tariffs. It reasoned that the NZa had committed to addressing the transparency issue in the pending objection procedure and that the immediate financial harm to practitioners did not outweigh the public interest in proceeding with the new tariffs. The decision allows the new rates to take effect but puts the regulator on firm notice: future cost models will need to be far more transparent to withstand judicial review.
SOURCE
Source: College van Beroep voor het bedrijfsleven
