Doug Hoffer: State Supreme Court dealt blow to transparency in OneCare Vermont case

This commentary is by Doug Hoffer, the Vermont state auditor.

The Court’s decision cloaks the use of hundreds of millions of Vermont taxpayer dollars in secrecy, allowing Vermont state agencies to protect themselves and their contractors from independent performance and spending oversight.

Hoffer for Auditor

Vermont State Auditor Doug Hoffer

Two years ago, my office requested some documents from OneCare Vermont, the state’s only Accountable Care Organization. For context, OneCare was accountable at that time for $1.2 billion in State, Federal and insurer payments to Vermont hospitals and providers. Our request was for payroll records so we could better understand two elements concerning their use of state funds. First, OneCare had provided state regulators with conflicting information about the salaries they were paying staff. We wanted to understand why. Second, OneCare requested an alarming 33% increase in total salary costs in just one year. Vermont taxpayers pay a large portion of those salaries through OneCare’s contract with the Department of Vermont Health Access (DVHA) and we wanted to know why they sought such a large increase.

As State Auditor, my job is to make sure that Vermont tax dollars are not wasted and that government-funded programs are performing as intended and at the level Vermonters deserve. My office has made similar requests of state contractors like OneCare many times over the years. Never before had we been rebuffed. Despite assurances that we would not disclose any personally identifiable information, OneCare argued that my office simply did not have the right to access their records. This despite two explicit provisions in OneCare’s contract with the state. The first appears in standard contract Attachment A, Specifications of Work to be Performed.

“Authorized representatives or agents of State of Vermont and the federal government shall have access to Contractor’s accounting records and the accounting records of its subcontractors upon reasonable notice and at reasonable times during the performance and/or retention period of the Contract for purposes of review, analysis, inspection, audit and/or reproduction.” [Section 2.7, Amendment 4, Contract # 32318.] 

The second is the audit provision that appears in contract Attachment C, a clause contained in all State contracts.

Records Available for Audit: The Party shall maintain all records pertaining to performance under this agreement…The records described shall be made available at reasonable times during the period of the Agreement and for three years thereafter or for any period required by law for inspection by any authorized representatives of the State or Federal Government.” [ Bulletin 3.5, Attachment C: Standard State Provisions for Contracts and Grants, #13

There is no real ambiguity here. The language authorizing the State Auditor to access records has never been in doubt before the Supreme Court’s ruling today. In their opinion, they write that my office is not explicitly listed as an “authorized representative” of the State, and therefore this standard contract provision (which every one of the hundreds of state contracts includes) does not apply to the State Auditor. Well, if access to records was restricted only to those explicitly listed than no entity would qualify because none are listed in that critical contract language. And if not the State Auditor, who?

The Supreme Court also argues that if anyone does have the right to access such records it would be the state agency who contracted with the outside party. But what if that agency would prefer certain facts not come to light? What if the agency is worried about how they themselves would be viewed if the Auditor’s Office accessed certain contractual records? Should DVHA (or any other state agency) be able to thwart the work of the State Auditor this way? If so, it is a betrayal of any sense of true government accountability and will encourage the outsourcing of state tax dollars to shield performance from independent scrutiny.

The whole point of an independently elected State Auditor is to hold state agencies accountable. We cannot do that if we need to seek permission from those we wish to evaluate. Those with something to hide will effectively be unpoliceable.

This is truly a dark day for Vermonters, since the sun will no longer shine on the use of hundreds of millions of dollars of your tax dollars.

I look forward to working with advocates of government accountability and transparency to find a remedy to today’s regressive ruling.

Images courtesy of Public domain and Hoffer for Auditor
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6 thoughts on “Doug Hoffer: State Supreme Court dealt blow to transparency in OneCare Vermont case

  1. Where is your concern about the millions of VT taxpayer dollars that Phil Scott has given to planned parenthood while not priding one cent for any Pro Life organization in the State ?

  2. Here, read this of UnitedHealthcare…MARCH 2022….this is insane…UnitedHealthcare is probably the largest in USA and they are unable to work with VT regulators… …so it seems they cut back. Astounding…VT needs insurance firms like UnitedHealthCare…not just a choice of OneCare or BCBS! Read:

    “March 3, 2022

    Please note that Alice Hyde Medical Center (including The Alice Center), Central Vermont Medical Center (including Woodridge Nursing & Rehabilitation), Champlain Valley Physicians Hospital (including Lake Champlain Physician Services and Skilled Nursing Facility), Elizabethtown Community Hospital, Porter Medical Center (including Helen Porter Rehabilitation and Nursing), and The University of Vermont Medical Center will no longer be participating in the UnitedHealthcare (“United”) Commercial Insurance provider network. This means most services provided at The University of Vermont Health Network’s (“UVMHN”) hospitals, outpatient facilities, clinics and provider practices will no longer be covered as in-network benefits under United Commercial plans.”

  3. “Reap and ye shall sow”….That is VT. It is DEMIOCRATS who refuse to allow ANY other insurance company to operate in VT….there IS no real choice, no competition, no lower rates. DEMOCRATS only allow Blue cross VT and OneCare to operate in VT….and now Mr. Hoffer is upset with OneOare? But almost EVERY other State allow whomever wants to sell insurnance, to do so. From small to huge, nationwide companies. That gives competition,. which lowers prices. Idiot VT is fixated on RESTRICTING any other insuarnce access, that is better, or cheaper. But it get’s much worse in VT.

    Hospitals are in trouble too. UVM Medical Center has asked for a huge 19.5% rate increase. Central Vt Hospital has asked for a 14.5% increase. I am sure One Care and Blue Cross have asked for increases. But dig DEEPER at UVM and CVH hospitals! No one wants to work there…from Janitor, to kitchen help to Physicians. UVM and CVH are begging for staff. Look at UVM website. They have an astounding 525 OPEN positions, and few takers. CVH, down by Montpelier, has a huge, huge 230 open positions (for it’s size). No one wants to work there. I know three doctors at CVH, all past retirement age, but they can’t just quit now…because CVH can’t fnd doctors to come to VT. VT is no where CLOSE to being competitive to attract them. And you can start with…amoung the highest income taxes, highest property taxes, housing and frigid weather. OH, and not very good schools for their children. That is very impotant to them. I know doctors that tried teh VT “dream” and left after a few years.

    How long can the Hospitals make it? 19% annual price increase? Then OneCare and BCBS will just follow withe their big % increases?? Then, no staff or doctors want to come to VT to work in our hospitals? It is a real mess. Democrats could wise up and FIST step is to WELCOME any out of state insurance companies, to offer insurance VT – for LOWER COST. Fat chance of that – the with numb nuts running the show.

    • Opps. I was a bit incorrect. It seems that United Health does have some linited coverage in VT…but most is thru OneCare and BCBS. OneCsre is a stale leftover of Shumlin single payer Care…VT should not be funding OneCare….VT should welcome competition to come in.

      Ask a current doctor, at UVM or CVH, why doctors don;\”t want to come to VT…and then address it!. I had a good one at CVH….years ago… he lasted 2.5 years..he was horrified at the schools…he went back to CT or NY, I recall.

  4. It is clear that the final contract form between OneCare and the State was emasculated. For one thing, the DVHA official State Program Manager (DVHA Programs and Operations Auditor) is designated to be solely responsible for the review of the invoices submitted by the Contractor. But there is, in my opinion, sufficient language in the contract documents that allow Auditor Hoffer to complete the requested audit process.

    Nonetheless, I’m suspect of Auditor Hoffer’s perfunctory protestations. This issue smacks of a proverbial CYB process (cover your butt, i.e., cover everyone’s butt). The Auditor is on record for making an attempt to fulfill his obligation by requesting the data. The Courts have denied the Auditor standing (the proverbial legal technicality). The Auditor has complained publicly ‘for the record’ – while doing nothing to revise and conform his request. And this is the last we, the taxpayers, will hear about this.

    I’d like to know who the State Program Manager (DVHA Programs and Operations Auditor) for this contract is. Apparently, the position is currently unoccupied. Go figure.

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