Like the rest of us, the business community is happy to hold state government accountable for the way it spends the public's tax dollars.
But what happens when the state contracts work out to a business? How accountable should that business be held for their own use of taxpayer money?
This is being debated because the state Department of Social Services has begun receiving Freedom of Information requests, beginning in 2004, for information regarding the Medicaid services provided by managed care organizations (MCOs).
Three companies and a non-profit group won contracts totaling more than $700 million to collectively operate Medicaid in Connecticut: Anthem Blue Cross and Blue Shield, Health Net, WellCare Health Plans and Community Health Network of Connecticut.
But advocates for low-income people in the state –- i.e. Medicaid recipients -– would like details about how those plans are operated; for instance, how much they are paying service providers. Not to mention whether little kids are being stiffed out of medical care.
Three of the four MCOs (all but WellCare) fought an initial request for information on the rates paid to doctors, but they seemed to meet rebuke wherever they turned. Gov. M. Jodi Rell ordered the rates released. Attorney General Richard Blumenthal agreed. A suit in Superior Court to block the release failed. And after the rates had already been given out, the Freedom of Information Commission ruled against the companies as well.
It seemed like a sound beating for the MCOs, and one that might push the General Assembly to cast more operations of state contractors beneath the public's purview.
Enter Keith J. Stover.
The bow-tied lobbyist for Robinson & Cole represents all MCOs in Connecticut, probably one of the biggest contracts around, and he has been making the case that if his clients are made to hand over further information –- like the criteria the companies use to set rates –- they would be forgoing a competitive advantage. That criteria is proprietary information, he says, which shouldn't be disclosed.
Not only that, but what about other state contractors? The FOI Commission ruled that the MCOs' information relative to their Medicaid operation should be public because it was part of their role in a "governmental function."
But what about providing IT help or paving a highway? Are those governmental functions? One provision in the legislature (part of one of three bills on the issue) would make companies receiving contracts of $250,000 or above susceptible to public inquiries, lowered from the current $2.5 million.
"There are broad implications across the community of state contractors," Stover said.
With that argument in hand, Stover produced the first victory for the MCOs since the pursuit of information began, getting the General Assembly's Insurance and Real Estate Committee to accept a proposal exempting numerous records from FOI.
That turned the tables on those seeking more disclosure.
Jane McNichol, executive director of the Legal Assistance Resource Center in Hartford, has been one of the key advocates in getting information out of the MCOs.
"This is a $700 million program that is state and federally funded…it certainly requires scrutiny," she said.
McNichol's organization employs Betty Gallo and Co., specialists in progressive causes, and through other bills out there for which they will push, both were ready to stick with the FOI Commission's decisions, rather than accept the Insurance Committee bill — at least after Stover was done with it.
For its part, the FOI Commission would be happy to see its decision stand, should no new legislation pass.
"We feel very good about the decisions that we issued — that current law supports the fact the managed care organizations when they are fulfilling their contractual role in regards to Medicare and Medicaid are subject to FOI requests," said commission director Colleen M. Murphy.
She agreed with Stover on one point: The issue won't just be about MCOs in the future.
"We weren't specifically focusing on the MCOs," she said.
"There are probably other companies down the road that will be affected."
Jonathan O'Connell is a Hartford Business Journal Staff Writer.