CRvB 26 mei 2010, AB 2010/222 m.nt. H.P. Wiersema

by Harald Wiersema
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Vaststelling pgb. Indicatie niet naar zorgzwaarte maar in functieklassen. Bevoegdheid zorgkantoor tot het stellen van beleidsregels. Cvz onbevoegd. Beleidsregel als vaste gedragslijn.

"Nu in artikel 2.6.6, achtste lid, van de Regeling aan het zorgkantoor de bevoegdheid is gegeven om het pgb op te hogen en enige wettelijke grondslag die Cvz de bevoegdheid toekent

om ter zake hiervan regels vast te stellen ontbreekt, is Cvz, gelet op het bepaalde in artikel 4:81 van de Awb, niet bevoegd terzake van die bevoegdheid beleidsregels vast te stellen. Dit

betekent dat de "Beleidsregel 2008" van Cvz niet kan worden aangemerkt als beleidsregel in de zin van artikel 1:3, vierde lid, van de Awb."

"Voor appellante was de geïndiceerde zorg ten tijde in geding niet naar zorgzwaarte maar in functieklassen vastgesteld. Nu zowel de brief van VWS als de "Beleidsregel 2008" van Cvz betrekking hebben op de situatie dat een verzekerde is geïndiceerd overeenkomstig een

zorgzwaartepakket, kan het Zorgkantoor in het geval van appellante het bedrag van € 142,98 per dag niet baseren op deze stukken. Dit betekent dat het besluit op bezwaar van 14 april 2008, voor zover dit de toekenning van het pgb over 2008 betreft, wegens strijd met het bepaalde in artikel 7:12, eerste lid, van de Awb voor vernietiging in aanmerking komt, evenals de aangevallen uitspraak waarbij dit besluit in stand is gelaten. Het Zorgkantoor dient een nieuw besluit op bezwaar te nemen, waarbij aannemelijk moet worden gemaakt welk bedrag betrokkene in een instelling zou kosten, onder aftrek van de woonlasten."

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