Yes, if you provide care under the Health Insurance Act or the Long-term Care Act and do not provide all of that care yourself. If you employed care staff in the past year, or had a locum or hired care provider work for you even once, you file an annual accountability report in DigiMV by 31 May.
An annual accountability report covers the previous calendar year, with a financial statement and a questionnaire. DigiMV is the portal in which you file it. The Dutch Healthcare Authority (NZa) supervises.
In short
- A sole proprietorship that provided all care personally is exempt. One locum or one care employee in the financial year makes you accountable, however briefly.
- Micro care providers file less: no notes, no management report and no auditor's report. You are micro if for two years in a row you meet two of the three limits: balance sheet total up to € 450,000, turnover up to € 900,000, fewer than 10 FTE employees.
- You request an extension from the NZa before 31 March, only in special circumstances. In April 2026 the NZa imposed orders subject to a penalty on nine district nursing providers for not supplying financial data.
In this article
Who must file an annual accountability report?
In principle every care provider whose care is paid for under the Health Insurance Act or the Long-term Care Act, including via a personal budget. The obligation is set out in article 40b of the Healthcare Market Regulation Act (NZa, Annual accountability report for care providers).
The act puts it briefly: a care provider accounts annually for the previous calendar year by publishing an annual accountability report. It consists of a financial statement and information that the minister requires by regulation (Healthcare Market Regulation Act, article 40b, version 1 September 2026).
Which documents you file depends on your legal form and size. A private limited company, foundation or association is in principle always accountable (CIBG, Private law legal entity). A partnership accounts as a whole, the partners do not need to do so separately, unless they also provide care outside the partnership (CIBG, Partnership).
Must a sole proprietorship or freelancer also file?
Only if in the financial year you had care provided by someone else. The CIBG asks one question: did you employ care staff in the past financial year or did you outsource care to someone, for example a locum? If the answer is yes, you are accountable. If it is no, you are a sole practitioner and file nothing (CIBG, Sole proprietorship).
The threshold is low. According to the CIBG it does not matter how often or for how long you used a locum, for example when you were ill or on holiday. Temporary staff or a care provider hired for a short time also count (CIBG, Sole proprietorship). A physiotherapist who had a locum cover two weeks of holiday must therefore file.
If you work as a subcontractor, you file your own report. The exception for the sole practitioner only applies if you are a sole proprietorship or partnership and provided the care exclusively yourself that year (CIBG, Subcontractor). If you work alone, but in a company, assume that you must file.
Who is exempt?
A number of groups do not need to file an annual accountability report (CIBG, Exceptions for care providers):
- providers who only supply care covered by supplementary insurance
- providers who only supply care under the Wmo
- employees and freelancers without staff who do not have care provided by others
- individual partners, if the partnership accounts as a whole
- providers who only do supporting work far from the core of care, such as transport, cleaning or catering
Be careful with supplementary insurance. The exception only applies if you supply such care exclusively. If you treat even some of your patients under basic insurance, you do not qualify.
What does a micro care provider file?
Less than a large provider. Since 1 January 2025 a micro care provider does not need to provide notes to the financial statement and does not need to file a management report or an auditor's report (CIBG, Micro care provider).
The report of a micro care provider has three parts: a short questionnaire, a limited financial statement and your signature. The questions cover, among other things, the average number of care providers per month and the number of unique patients or clients. The answers are not public, but do go to organisations such as the NZa, health insurers, municipalities and the FIOD (CIBG, Micro care provider).
| Micro care provider | What you file | Public? |
|---|---|---|
| Legal entity, such as a company | Limited balance sheet and limited profit and loss account | Balance sheet yes, profit and loss account no |
| Partnership | Limited balance sheet and limited statement of income and expenditure | Not public |
| Sole proprietorship | Limited balance sheet and limited statement of income and expenditure | Not public |
The signature is public. After signing you can no longer change anything. If you then discover a serious error, you report it in DigiMV, and that report is also made public (CIBG, Micro care provider).
When is it due, and can you get an extension?
By 31 May of the year after the financial year. An extension is only possible in special circumstances, and you request it from the NZa by 31 March (CIBG, Supervision and enforcement by the NZa). According to the NZa, the first financial year in which you are accountable also counts as a special circumstance (NZa, Annual accountability report for care providers).
Since 1 January 2026 you can also get an extension if your accountant or bookkeeping firm is delayed by capacity problems. The NZa can then grant an extension until 1 October of that year (CIBG, Supervision and enforcement by the NZa). You must still request that extension before 31 March.
What happens if you do not file or file late?
The NZa can take enforcement action. It checks whether care providers file on time, completely and correctly, and chooses each year where to deploy its capacity. It also checks a group of randomly selected providers (NZa, Annual accountability report for care providers).
A missing annual report is also a signal for further investigation. In April 2026 the NZa imposed orders subject to a penalty on nine district nursing providers because they did not supply the financial data requested. The sixteen providers investigated came from a risk analysis in which the NZa looked, among other things, at the presence and content of the annual accountability report. The findings were shared with health insurers and the CIBG (NZa, Order subject to a penalty for 9 district nursing providers, 22 April 2026).
The stakes are rising. In July 2026 the government announced that failing to file the annual report will become a reason to prohibit a profit distribution, and that repeated failure can lead to withdrawal of the admission licence. That is a proposal in the Wibz bill, not yet a rule (Government of the Netherlands, 3 July 2026).
Who looks at your annual accountability report?
More parties than you might think. According to the NZa, the public part can be used by, for example, internal supervisors, client councils and journalists (NZa, Annual accountability report for care providers). Even as a micro care provider your answers go to health insurers and supervisors.
Researchers also use the public annual reports. A study of care providers in the Netherlands used that data to see whether financially strong providers pay less interest on long-term loans. The researchers did not find that relationship. Higher financial reserves gave no visible advantage in the cost of capital (Wackers, Smit, Stadhouders & Jeurissen, 2023). That concerned larger institutions, but it shows that your figures take on a life of their own once published.
Administrative burden is a well-known concern in care. Research on long-term care concluded that these costs make up a considerable share of spending, but remain hidden in regular statistics (Hagenaars et al., 2021). For a small provider the lesson is practical: keep your accounts in order all year, and the annual report in May takes hours instead of weeks.
Sources
- Healthcare Market Regulation Act (Wmg), article 40b, version 1 September 2026, read via the BWB repository (in Dutch). wetten.overheid.nl
- NZa, Annual accountability report for care providers (in Dutch), accessed 1 November 2026. nza.nl
- CIBG, Sole proprietorship (in Dutch), accessed 1 November 2026. jaarverantwoordingzorg.nl
- CIBG, Partnership (in Dutch), accessed 1 November 2026. jaarverantwoordingzorg.nl
- CIBG, Private law legal entity (in Dutch), accessed 1 November 2026. jaarverantwoordingzorg.nl
- CIBG, Subcontractor (in Dutch), accessed 1 November 2026. jaarverantwoordingzorg.nl
- CIBG, Exceptions for care providers (in Dutch), accessed 1 November 2026. jaarverantwoordingzorg.nl
- CIBG, Micro care provider (in Dutch), accessed 1 November 2026. jaarverantwoordingzorg.nl
- CIBG, Supervision and enforcement by the NZa (in Dutch), accessed 1 November 2026. jaarverantwoordingzorg.nl
- NZa, Order subject to a penalty for 9 district nursing providers, 22 April 2026 (in Dutch). nza.nl
- Government of the Netherlands, Cabinet tightens rules on profit distributions and business operations in care, 3 July 2026 (in Dutch). rijksoverheid.nl
- Wackers, E., Smit, R., Stadhouders, N. & Jeurissen, P. (2023). Assessing the relation between financial performance and long-term bank loan interest rates for healthcare providers in the Netherlands: a panel data analysis. The European Journal of Health Economics, 25(5), 845-855. doi.org
- Hagenaars, L.L., Van Hilten, O., Klazinga, N.S. & Jeurissen, P. (2021). Track and trace of administrative costs in the Dutch long-term care system. Journal of Long-Term Care, 2021, 318. doi.org