Do you have a healthcare practice? Prepare for new enforcement by the Internal Revenue Service

As a healthcare entrepreneur, do you use self-employed workers and fear losing your staff due to the upcoming enforcement by the Internal Revenue Service? Don’t panic. It is more important than ever to be well prepared. By keeping yourself well informed and getting a clear overview of your self-employed pool, you can avoid problems.

What’s in store for you as a healthcare entrepreneur?

Although the Tax Office has indicated that inspectors will not be on the doorstep everywhere immediately, in principle any organization can be inspected. The Cabinet has requested that the enforcement strategy focus on high-risk areas, such as:

• Forced self-employment;
• Underpayment;
• Evident false self-employment;
• Labor migration constructions.

Good news: practices that demonstrably take steps to prevent false self-employment will not be dealt with immediately. There is a transition period until 2025 during which companies can show they are actively working on improvements without imposition of penalty fines. But beware: an after-tax payroll tax penalty is not ruled out if false self-employment is found to exist.

How do you control the situation?

The key is a structured approach. Here are some concrete steps you can take:

1. Map all self-employment contracts in your practice. Make sure you have a complete record of who you hire and on what basis.

2. Conduct a risk inventory. Use the following metrics to review each contract:

• Nature and duration of work;
• Who determines the method of work and working hours?
• Is there a distinction between self-employed and salaried workers?
• Is there an obligation to perform work personally (or is substitution possible)?
• Is the contractual relationship established equally?
• How are remuneration, rates and payment regulated?
• Are entrepreneurial criteria met, such as commercial risk and multiple clients?

3. Use tools. The Tax Office offers a handy decision framework here. You can also complete the special web module to assess the employment relationship.

If you incorporate these steps into a model, you can demonstrate that you are actively working to prevent false self-employment in your practice.

Practice over theory: be alert

Remember that practice is leading. What is on paper counts less than what the collaboration looks like in reality. Do not try to circumvent legislation with constructions such as setting up a private limited company to disguise false self-employment. If the intention is purely aimed at avoiding an employment relationship, this can still be considered false self-employment.

Get help

Preventing false self-employment requires a proactive and strategic approach. Want help qualifying your employment relationships, amending contracts or reviewing employment agreements? Contact one of our employment law specialists. Together, we’ll make sure your organization is ready for the future.

Want to read more? Check out our related articles:

• VBAR law and enforcement of bogus self-employment
• Opheffing handhavingsmoratorium Wet DBA per 2025 (in Dutch)

Questions?

Do you have any questions on this topic? If so, feel free to contact one of our employment law specialists. Then contact one of our lawyers by email, phone or fill in the contact form for a no-obligation initial consultation. We will be happy to think along with you.