Dental Benefit Providers, Inc. v. Eiseman
86 A.3d 932
Pa. Commw. Ct.2014Background
- RTKL petitions seek records of rates paid by Medicaid MCOs to subcontractors and by subcontractors to dental providers in SE Pennsylvania.
- DPW has contracts with five MCOs but no direct contracts with the subcontractors or providers whose rates are at issue.
- Parties asserted exemptions including Trade Secrets Act, RTKL 708(b)(11), and DOH regulation 28 Pa. Code § 9.604; OOR ordered disclosure.
- OOR relied on Eiseman I and Lukes to conclude Provider Rates are accessible; MCO Rates are treated as exempt per Eiseman I.
- DPW argued no possession of Provider Rates and no direct DPW contract with Subcontractors; 506(d) analysis should apply only to third-party records.
- Court reverses OOR: MCO Rates exempt; Provider Rates not accessible under 901 or 506(d); Lukes theory rejected under current RTKL.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Provider Rates are accessible under RTKL 506(d). | Requester contends DPW constructive possession via contracts; 506(d) covers third-party records. | Majority: no DPW contractual relationship with Subcontractors; Provider Rates do not directly relate to DPW’s government function. | Provider Rates not accessible under 506(d). |
| Whether DPW has possession of Provider Rates under RTKL 901. | DPW has contractual right to access records; Standard Contract seeks DPW access. | Provider Rates are not DPW records; no DPW creation/receipt of Provider Rates. | Provider Rates are not “records” of DPW under 901; not in DPW possession. |
| Whether Lukes controls the outcome under the current RTKL. | Lukes should apply, given public funds flow and DPW constructive control. | Current RTKL requires section 506(d) analysis; Lukes rejected. | Lukes rejected; does not control interpretation under current RTKL. |
Key Cases Cited
- Department of Public Welfare v. Eiseman, 85 A.3d 1117 (Pa.Cmwlth.2014) (Eiseman I: MCO Rates exempt under RTKL; informs 506(d) analysis for Provider Rates)
- Lukes v. Department of Public Welfare, 976 A.2d 609 (Pa.Cmwlth.2009) (broad agency possession rationale rejected under current RTKL)
- Office of the Budget v. Office of Open Records, 11 A.3d 618 (Pa.Cmwlth.2011) (payroll records of contractor not agency records under RTKL)
- West Chester University of Pennsylvania v. Browne, 71 A.3d 1064 (Pa.Cmwlth.2013) (private contractor records related to government function can be public if records relate to government function)
- Bowling v. Office of Open Records, 75 A.3d 453 (Pa.Cmwlth.2013) (RTKL review is de novo for legal questions)
- ASCI II (Allegheny Cnty. Dep’t of Admin. Servs./A Second Chance Inc. v. Parsons), 61 A.3d 336 (Pa.Cmwlth.2013) (two-prong test for 506(d): government function and direct relation)