[J-29A-C-2015] [MO: Saylor, C.J.]
IN THE SUPREME COURT OF PENNSYLVANIA

EASTERN DISTRICT

**DENTAL BENEFIT PROVIDERS, INC.**
**AND UNITEDHEALTHCARE OF PENNSYLVANIA, INC. D/B/A** 
**UNITEDHEALTHCARE COMMUNITY**
**PLAN AND HEALTHAMERICA PENNSYLVANIA, INC., D/B/A**  **COVENTRYCARES,**

**Appellees**

**v.**

**JAMES EISEMAN, JR. AND THE PUBLIC**
**INTEREST LAW CENTER OF PHILADELPHIA,** 

**Appellants :** 

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**: No. 48 EAP 2014** 

**Appeal from the Order of the**
**Commonwealth Court entered**
**02/19/2014 at No. 945 CD 2013 reversing the determination entered on**  **05/07/2013 of the Office of Open**
**Records at No. AP2012-2017.**

**ARGUED: May 5, 2015**

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**: AETNA BETTER HEALTH INC., HEALTH**  **PARTNERS OF PHILADELPHIA, INC., KEYSTONE MERCY HEALTH PLAN,**  **AND DENTAQUEST, LLC,**

**Appellees**

**v.**

**JAMES EISEMAN, JR., AND THE PUBLIC**
**INTEREST LAW CENTER OF PHILADELPHIA,**  **:**

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**: No. 49 EAP 2014** 

**Appeal from the Order of the**
**Commonwealth Court entered**
**02/19/2014 at No. 957 CD 2013 reversing the determination entered on**  **05/07/2013 of the Office of Open**
**Records at No. AP2012-2017.**

**ARGUED: May 5, 2015 [J-29A-C-2015] [MO: Saylor, C.J.] - 2** 

**Appellants :** 

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**DEPARTMENT OF PUBLIC WELFARE,**

**Appellee**

**v.**

**JAMES EISEMAN, JR., AND THE PUBLIC**
**INTEREST LAW CENTER OF PHILADELPHIA,** 

**Appellants :** 

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**: No. 50 EAP 2014** 

**Appeal from the Order of the**
**Commonwealth Court entered**
**02/19/2014 at No. 958 CD 2013 reversing the determination entered on**  **05/07/2013 of the Office of Open**
**Records at No. AP2012-2017.**

**ARGUED: May 5, 2015**

DISSENTING OPINION

MR. JUSTICE STEVENS DECIDED: October 27, 2015

**The public has the statutory right of access to the rate s of payments made by** 

**Subcontractors to providers of dental health services to M edicaid enrollees in the** 

**HealthChoices Southeastern Zone (the “Provider Rates”) . Thus, as I find that the** 

**Provider Rates should be disclosed and would reverse the Commonwealth Court, I** 

**respectfully dissent.**

**The Majority holds that the “highly generalized princi ples” established under 65** 

**P.S. § 67.506(d)(1) that are applicable to records in the possession of third parties does** 

**not compel disclosure of the Provider Rates. More speci fically, the Majority concludes** 

**Section 506(d)(1) contemplates an actual contract with a third party in possession of** 

**salient records, and finding no such actual contract exists b etween the Subcontractor,** 

**who has physical possession of the agreements evidencing the Provider Rates, and** **[J-29A-C-2015] [MO: Saylor, C.J.] - 3**

**DPW, the Commonwealth agency at issue, the Majority af firms the Commonwealth** 

**Court’s decision upon this basis.**

**In my view, the Majority has interpreted Section 506 (d)(1) of the Right-to-Know** 

**Law (“RTKL”) too narrowly and has not given the RTKL the liberal construction** 

**necessary “to effectuate its purpose of promoting access to official government** 

**information in order to prohibit secrets, scrutinize act ions of public officials, and make** 

**public officials accountable for their actions.” Levy v. Senate of Pennsylvania, 619 Pa.** 

**586, 619, 65 A.3d 361, 381 (2013) (quotation and qu otation marks omitted). As this** 

**Court has recognized, the objective of the RTKL is “to empower citizens by affording** 

**them access to information concerning the activities of the ir government.” SWB** 

**Yankees LLC v. Wintermantel, 615 Pa. 640, 662, 45 A.3 d 1029, 1042 (2012).** 

**Accordingly, as to this issue, I am more inclined to accept the dissenting view of** 

**Commonwealth Court Judge McCullough, who relevantly st ated that:** 

**In this case, DPW is the party principal to the subcontract s between**  **the [Managed Care Organization (“MCO”)] and the thi rd party**  **Subcontractors. The MCOs lack authority to enter into sub contracts with**  **the Subcontractors, and the only way in which the subcontr acts can**  **become valid and enforceable under the HealthChoices Ag reement is if**  **DPW ratifies or approves the subcontracts as the principal . Therefore,**  **because the Subcontractors have directly contracted with DP W as**  **principal and are in possession of the Provider Agreemen ts (“in**  **possession of a party with whom the agency has contracted”) , . . . DPW**  **possesses “public records” for purposes of [S]ection 506(d)( 1) of the** 
**RTKL. Moreover, as used in the RTKL, the term “governmental**  **function” is materially ambiguous; yet, it should be construed gene**  **rally “to connote an act of delegation of some substantial facet of the agen**  **cy’s role and responsibilities.” [SWB Yankees LLC, 615 Pa. at 664,] 4**  **5 A.3d [at 1043]. So long as the requested documents directly relate to th**  **e governmental function that is contracted out to the third party, the**  **records are considered to be in the agency’s possession under the RTKL.**  **65 P.S. § 67.506(d)(1).** **[J-29A-C-2015] [MO: Saylor, C.J.] - 4 In this case, the request for Provider Agreements and**  **Provider Rates falls squarely within the terms of the Subcontrac**  **tors’ contractual duties and explicit governmental undertakings. Via sub**  **-contractual arrangements, the Subcontractors assume DPW’s governmental**  **obligation to implement Medicaid and ensure that dent al care is available**  **for Medicaid recipients. Pursuant to their governmenta l and contractual**  **duties, the Subcontractors are not only obligated to se cure dental services**  **through Provider Agreements, but are also required to negotiate Provider**  **Rates with the dental providers. On these facts, . . . the Provider**  **Agreements and Provider Rates directly relate to the S ubcontractors’**  **performance of a government function. These agreem ents and rates are**  **indispensably necessary to effectuate Medicaid and repr esent the [“]very**  **thing[”] the Subcontractors contractually agreed to do for and on behalf of** 
**DPW.**

**Dental Benefit Providers, Inc. v. Eiseman, 86 A.3d 932 , 944-45 (Pa. Cmwlth. 2014) (en** 

**banc) (McCullough, J., dissenting).**

**In addition to affirming the Commonwealth Court’s or der on the point that Section** 

**506(d)(1) contemplates an actual contract with a third p arty in possession of salient** 

**records, which is lacking in this case, the Majority further discounts the policy** 

**considerations favoring public access to downstream Provider Rates. As Appellants’** 

**amicus curiae indicates, the lack of access to the negotiated Provider Rates prevents a** 

**full understanding of the relationship between fees an d access, which is critical to** 

**addressing disparities in health care cost, quality, and outcomes. Brief of Amicus** 

**Curiae Professor Daniel Polsky, Ph.D. at 5. Moreover, lack of information concerning** 

**the Provider Rates prevents fully informed policy decisio ns regarding the state of** 

**Medicaid spending and impedes necessary analysis required to improve the functioning** 

**of the health care system. See id. at 6, 8. Furthe rmore, transparency in the** 

**government’s oversight of Medicaid is necessary toward th e interrelated objective of** 

**improving healthcare quality. Id. at 9. [J-29A-C-2015] [MO: Saylor, C.J.] - 5** 

**Respectfully, the Majority’s decision today prevents the public from holding** 

**government agencies accountable and does not require di sclosure of information** 

**merely because a “middleman” is involved in the perfor mance of the governmental** 

**duties. This is contrary to the remedial legislative in tent of the RTKL. Accordingly, as I** 

**would require disclosure of the Provider Rates under Se ction 506(d)(1) of the RTKL, I** 

**dissent.**