UnitedHealthcare, et al v Eiseman, et al, Aplts. (dissenting)
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[J-28A-2015, J-28B-2015 and J-28C-2015] [MO: Saylor, C.J.] IN THE SUPREME COURT OF PENNSYLVANIA EASTERN DISTRICT COMMONWEALTH OF PENNSYLVANIA, : DEPARTMENT OF PUBLIC WELFARE, : : Appellee : : : v. : : : JAMES EISEMAN, JR. AND THE PUBLIC : INTEREST LAW CENTER OF : PHILADELPHIA, : : Appellants : AETNA BETTER HEALTH, INC., HEALTH : PARTNERS OF PHILADELPHIA, INC., : AND KEYSTONE MERCY HEALTH : : PLAN, : Appellees : : : : v. : : JAMES EISEMAN, JR., AND THE PUBLIC : INTEREST LAW CENTER OF : PHILADELPHIA, : : Appellants : UNITEDHEALTHCARE OF PENNSYLVANIA, INC. D/B/A UNITEDHEALTHCARE COMMUNITY PLAN AND HEALTHAMERICA PENNSYLVANIA INC. D/B/A COVENTRYCARES, : : : : : : : No. 45 EAP 2014 Appeal from the Order of the Commonwealth Court entered on 02/19/2014 at No. 1935 CD 2012 affirming in part and reversing in part the determination entered on 09/17/2012 of the Office of Open Records at No. AP2011-1098. ARGUED: May 5, 2015 No. 46 EAP 2014 Appeal from the Order of the Commonwealth Court entered 02/19/2014 at No. 1949 CD 2012 affirming in part and reversing in part the determination entered on 09/17/2012 of the Office of Open Records at No. AP2011-1098. ARGUED: May 5, 2015 No. 47 EAP 2014 Appeal from the Order of the Commonwealth Court entered 02/19/2014 at No. 1950 CD 2012 affirming in part and reversing in part the determination entered on 09/17/2012 of the Office of Open Appellees : Records at No. AP2011-1098. : : ARGUED: May 5, 2015 v. : : : JAMES EISEMAN, JR. AND THE PUBLIC : INTEREST LAW CENTER OF : PHILADELPHIA, : : Appellants : DISSENTING OPINION MR. JUSTICE EAKIN DECIDED: October 27, 2015 I agree with the Commonwealth Court’s majority that documents containing MCO Rates are not “financial records” within § 102 of the RTKL, 65 P.S. § 67.102. See Dep’t of Public Welfare v. Eiseman, 85 A.3d 1117, 1127 (Pa. Cmwlth. 2014) (en banc) (“Because MCO Rates are not disbursed ‘by an agency,’ [the] OOR erred in concluding MCO Rates are ‘financial records.’”). MCO Rates are rates set by a private company, not an agency. The private company disburses the funds — the agency does not. While the entire scheme of payment immediately suggests bureaucratic confusion and obfuscation, the plain language of the RTKL does not cover this situation — perhaps it should, but as it currently exists, in my judgment it does not. I would remand the matter to the OOR to decide, in the first instance, whether the MCO Rates are exempt from disclosure under § 708(b)(11). Contra id. (“Because we conclude the MCO Rates are not ‘financial records,’ we next consider the RTKL exceptions that OOR did not fully analyze based on its adherence to Lukes[ v. Dep’t of Public Welfare, 976 A.2d 609 (Pa. Cmwlth. 2009)]. Typically, we would remand to [the] OOR to serve as fact-finder.”). Thus, I respectfully dissent. [J-28A-2015, J-28B-2015 and J-28C-2015] [MO: Saylor, C.J.] - 2
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