The board has been considering whether to issue a permit, called a certificate of need, to doctors seeking to open a free-standing surgical center in Colchester that would not be affiliated with a hospital.
The doctors have been represented mainly by Amy Cooper, the executive director of HealthFirst, an organization for providers at physician-owned practices. The doctors have been called simply “Physicians A-P” in regulatory documents, where their lawyers argue that using their real names would subject them to retaliation by hospitals.
The board decided Oct. 20 that doctors involved in the Green Mountain Surgery Center have to disclose their financial interests in the center, but their names cannot be disclosed to the public or to the Vermont Association of Hospitals and Health Systems, which has been intervening in the case.
The decision came two months after the board asked that the lawyers for the independent doctors disclose the “name, percentage of ownership interest, and amount of initial capital investment” in the surgical center.
The lawyers for the independent doctors argued Oct. 5 that disclosing the doctors’ financial stakes and names would violate the Vermont Public Records Act and pose “a real risk of the investors’ loss of employment if their identity as (ambulatory surgical center) investors are made public.”
“If the investors are independently employed physicians and the hospitals find out they have invested in the (surgical center), the hospitals could adversely affect the physicians’ credibility and make it difficult for them to schedule and perform their surgical procedures, effectively cutting off their livelihood,” the lawyers for the doctors wrote.
“A physician who is unable to get his/her patients scheduled for surgery quickly loses patients,” the lawyers wrote. “Public disclosure could also adversely affect any chance of a hospital job offer in the future.”
The Vermont Association of Hospitals and Health Systems, which has been intervening in the case along with Northwestern Medical Center in St. Albans, argued Oct. 10 that the names and financial information of the applicants is public information.
Additionally, the hospital association wrote that both it and Northwestern “must have access to financial information about the applicant, including percentage of ownership, amount of capital investment, and the terms of that investment.”
“Anything less than complete access to information submitted by the applicant in response to the board’s questions will impair VAHHS’ and NMC’s ability to evaluate the impact the (surgical center) will have on VAHHS’ members and NMC,” lawyers for the hospital association wrote.
“This lack of transparency will also hinder VAHHS’ and NMC’s ability to respond to (the surgical center’s) conclusions that the ambulatory surgery center will meet the certificate of need standards,” the lawyers wrote.
The hearing officer for the Green Mountain Care Board wrote Oct. 20 that the financial information about the investors in the surgical center is not exempt from the Vermont Public Records Act because it does not have to do with state employees, but that the names can be withheld.
“In particular, questions whether physician investments in the project would or could affect the way in which referrals are given or how medical care is dispensed are questions of the highest public importance,” the hearing officer wrote, saying the information “may indicate a need for further inquiry by the board.”
On Wednesday, Vermont Legal Aid’s Office of the Health Care Advocate asked the board to allow it to see the names of the doctors involved in the case, saying, “We cannot fully fulfill our role without access to all available information.”
The board declined to comment on whether it would consider the request, because it is part of an ongoing case.
