Indications for and claims to dental specialties: regulatory framework
Dental specialties in the Netherlands have resulted from the growing demand for specialized dental care for patients with complex disorders. The Healthcare Insurance Act of 1964 and the Health Insurance Act of 2006 established an important structural foundation for such care within the healthcare system in the Netherlands. The regulatory framework for dental specialties distinguishes among several categories, including patients with congenital or acquired dental anomalies, physical or mental disorders or medically compromised patients. There is, however, a considerable lack of clarity concerning claims to reimbursement for dental specialties in the standard health insurance package. Article 2.7 of the Healthcare Insurance Decree and the ‘proportionality principle’ play a central role in this: aiming for a good, reliable solution to arrive at a level of dental health appropriate and comparable to the oral situation prior to the incident in which the claim to dental specialist care originated. In this 1st part of a 2-part article, the regulatory framework concerning dental specialties is described.