Senate Leadership
May 31, 2006
Looney: No Additional Taxpayers' Money to Medicaid MCOS Until They Open Their Books
Asks Gov. to not negotiate any payment increases until they disclose how they are spending the $700 million a year they already receive
State Senate Majority Leader Martin M. Looney (D-New Haven) today said there should be no negotiations on payment increases to Medicaid Managed Care Organizations (MCOs) until those organizations open their books to public scrutiny on how they spend the nearly $700 million a year they currently receive in taxpayers' money. Despite two decisions from the Freedom of Information Commission, the MCOs' expenditures of public money remain secret.
Sen. Looney said he has written a letter to Governor Rell asking to use the current negotiations between the Department of Social Services and the MCOs for increased payments as leverage to force the MCOs to be accountable for how they spend the taxpayers' money.
"Right now, the MCOs are all negotiating with DSS for a substantial increase in their capitated payments effective July 1, 2006, as well as with respect to how much they will have to pay back to DSS given the removal of all of their responsibility for behavioral health services on January 1, 2006-without any corresponding reduction in their payments to date," Sen. Looney wrote to the governor. "I of course support the right of the MCOs to file an appeal in court of any rulings they do not agree with, issued by the FOIC or any other state agency...[but] If they won't tell the taxpayers where their money is going, then surely they cannot expect the taxpayers to give them still more."
Sen. Looney also noted the action to force accountability would cause no hardship. "No one's access to health care will be affected, because the substantive provisions of the contracts are not affected and the MCOs received a retroactive 4% increase this year-when you and the General Assembly had only approved a 2% increase in their budget.
Sen. Looney urged the governor to force the MCOs to act, "Accordingly, I urge you to instruct both DSS and the Office of Policy and Management that, as long as the MCOs are going to challenge their obligation to disclose under the FOIA how the taxpayers' money is being spent under their state contracts, these two agencies, while negotiating for repayment of the post-January 1st overpayments, are forbidden from granting any cost of living increases in the MCO's capitated payments."
Sen. Looney said such action by the governor would be consistent with her stated position on the controversy. "The governor has on several occasions indicated that she believes that the Medicaid MCOs should be held directly accountable to the taxpayers and that how state money is spent under their contracts should be transparent to the public. I agree with that position, as does the Attorney General, the Comptroller and the State Health Care Advocate, and individual health advocates statewide. This action would help toward that end."
Letter to Governor Rell:
Honorable M. Jodi Rell
Governor
State Capitol
Hartford, CT 06106
Dear Governor Rell:
I write because of my concern with the continuing unwillingness of the four Medicaid Managed Care Organizations ("MCOs") with which the Department of Social Services ("DSS") contracts to open up their books to public scrutiny regarding how about $700 million/year of the taxpayers' money is being spent, and to urge you to take two very specific steps toward contractor accountability which are available to you right now, while the contractors persist in this position.
You have on several occasions indicated that you believe that the Medicaid MCOs should be held directly accountable to the taxpayers and that how state money is spent under their contracts should be transparent to the public. I agree with that position, as do the Attorney General, the Comptroller and the State Health Care Advocate, and individual health advocates statewide. All agree that the MCOs are performing a governmental function and so are directly subject to the Freedom of Information Act ("FOIA") under Conn. Gen. Stat. §1-200(11).
Nevertheless, despite two decisions from the Freedom of Information Commission ("FOIC") so ruling, the MCOs are refusing to open up their books to public scrutiny, and have obtained a stay of those rulings pending a court appeal. In addition, DSS has been unwilling to use its clear contractual authority to obtain any documents requested by the public, independent of the FOIA, as you ordered the department to use in the past before the FOIC even ruled that the MCOs are subject to FOIA.
Right now, the MCOs are all negotiating with DSS for a substantial increase in their capitated payments effective July 1, 2006, as well as with respect to how much they will have to pay back to DSS given the removal of all of their responsibility for behavioral health services on January 1, 2006-- without any corresponding reduction in their payments to date. I of course support the right of the MCOs to file an appeal in court of any rulings they do not agree with, issued by the FOIC or any other state agency. However, neither you nor the taxpayers have to reward them for doing so, and for refusing to be accountable regarding how the taxpayers' money is being spent. If they won't tell the taxpayers where their money is going, then surely they cannot expect the taxpayers to give them still more.
Imposing such a moratorium on giving more state money to the MCOs will cause no hardship. No one's access to health care will be affected, because the substantive provisions of the contracts are not affected and the MCOs received a retroactive 4% increase this year-- when you and the General Assembly had only approved a 2% increase in their budget.
Accordingly, I urge you to instruct both DSS and the Office of Policy and Management that, as long as the MCOs are going to challenge their obligation to disclose under the FOIA how the taxpayers' money is being spent under their state contracts, these two agencies, while negotiating for repayment of the post-January 1st overpayments, are forbidden from granting any cost of living increases in the MCO's capitated payments. I also note that, since one MCO (WellCare) has not appealed the FOIC's rulings, it has no excuse for refusing to accept that obligation, and DSS should insist without further delay that it do so.
Thank you for your continued interest in and attention to this vital matter of public interest.
Sincerely,
Martin M. Looney
Majority Leader
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