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Crowe narrows information defined as confidential for merged health system

Nathan Baker • Mar 7, 2018 at 2:12 PM

A bill filed to keep Ballad Health’s business information confidential now heads to the state Senate floor after its scope was narrowed to incorporate the concerns of state residents and open government officials.

The Senate Health and Welfare Committee unanimously approved a bill Wednesday by Johnson City Sen. Rusty Crowe, the committee’s chair, after changing it to legislation hashed out by representatives from Ballad, the state Department of Health, the Attorney General’s office and the state Coalition for Open Government.

“I think what you’re going to have after this is one of the most open hospital systems in state,” Crowe said after the committee meeting. “Everything, even proprietary items are going to go to state, and (the Health Commissioner) can at his or her discretion, still release that information after due process.”

The original bill would have made confidential 14 types of information reported to the state by Ballad as part of a certificate of public advantage agreement, including budgets and expenditures, business and marketing plans, financial audits, facility assessments, employment agreements, facility closures or repurposing and changes to service lines.

The certificate of public advantage, or COPA, approved by the state allowed Mountain States Health Alliance and Wellmont Health System to merge, despite having little competition regionally in some areas of health care.

In return for the merger approval, the two systems agreed to put controls on costs and interaction with independent providers, and committed to providing the state with information proving the controls were in place.

Crowe said the original intent of the bill was to protect proprietary business information reported to the state from being made public, which could give competing systems in other regions an upper hand.

“I think from a business perspective, it’s very important that they be on even playing field with other systems,” the senator said.

The amended bill keeps eight types of information confidential, but it does not name facility assessments, consulting reports, facility closures or repurposing, additions and deletions of service lines and financing among those. Instead of financial audits, only audit working papers would be considered proprietary.

Debora Fisher, executive director of the Coalition for Open Government, said the bill’s new language seemed reasonable after the “very broad” first draft.

“What we were concerned about was that it made all records of the COPA monitor confidential,” she said. “This bill doesn’t do that. This final bill is more in line with what we see on other proprietary information collected by the state being confidential.”

The bill also gives the Health Commissioner the ability to reveal records defined as confidential if the Commissioner sees fit as part of the COPA monitoring and reporting process. The proposed law requires the Commissioner to notify a system under a COPA of the intent to disclose the information, and sets up a review process if the system challenges the release of the information.

In an emailed statement, Ballad spokesperson Teresa Hicks said the system approved of the amended bill.

“We support this bill and appreciate the work of sponsors Sen. Rusty Crowe and Rep. Gary Hicks, the attorney general’s office and the department of health to ensure the language of the bill keeps the public informed of our progress under the COPA while continuing to protect sensitive and proprietary information,” the statement read.

Likewise, a joint statement from the state Department of Health and the Attorney General’s office said the bill “allows for transparency but also protects proprietary information that is crucial to the regulatory process but for business and financial reasons in not appropriate to be in the public realm.”

The bill will be heard in the Senate in the next couple of weeks. Its companion in the House has been assigned to the chamber’s Health Subcommittee, but has not yet been scheduled for a hearing.

Previously reported:

A bill filed to keep Ballad Health’s business information confidential now heads to the state Senate floor after its scope was narrowed to incorporate the concerns of state residents and open government officials.

The Senate Health and Welfare Committee unanimously approved a bill Wednesday by Johnson City Sen. Rusty Crowe, the committee’s chair, after changing it to legislation hashed out by representatives from Ballad, the state Department of Health, the Attorney General’s office and the state Coalition for Open Government.

“I think what you’re going to have after this is one of the most open hospital systems in state,” Crowe said after the committee meeting. “Everything, even proprietary items are going to go to state, and (the Health Commissioner) can at his or her discretion, still release that information after due process.”

The original bill made confidential 14 types of information reported to the state by Ballad as part of a certificate of public advantage agreement, including budgets and expenditures, business and marketing plans, financial audits, facility assessments, employment agreements, facility closures or repurposing and changes to service lines.

The certificate of public advantage, or COPA, approved by the state allowed Mountain States Health Alliance and Wellmont Health System to merge, despite having little competition regionally in some areas of health care.

In return for the merger approval, the two systems agreed to put controls on costs and interaction with independent providers, and committed to providing the state with information proving the controls were in place.

Crowe said the original intent of the bill was to protect proprietary business information reported to the state from being made public, which could give competing systems in other regions an upper hand.

“I think from a business perspective, it’s very important that they be on even playing field with other systems,” the senator said.

The amended bill keeps eight types of information confidential, but it does not name facility assessments, consulting reports, facility closures or repurposing, additions and deletions of service lines and financing among those. Instead of financial audits, only audit working papers would be considered proprietary.

Debora Fisher, executive director of the Coalition for Open Government, said the bill’s new language seemed reasonable after the “very broad” first draft.

“What we were concerned about was that it made all records of the COPA monitor confidential,” she said. “This bill doesn’t do that. This final bill is more in line with what we see on other proprietary information collected by the state being confidential.”

The bill also gives the Health Commissioner the ability to reveal records defined as confidential if the Commissioner sees fit as part of the COPA monitoring and reporting process. The proposed law requires the Commissioner to notify a system under a COPA of the intent to disclose the information, and stipulates a review process if the system challenges the release of the information.

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