State Auditor Doug Hoffer has sued OneCare Vermont after the company refused to hand over salary information.
Attorney General TJ Donovan filed the suit on Hoffer’s behalf on Wednesday, trying to force OneCare to provide payroll data from 2019 and 2020 — including 1099s, W2s, and benefits information — to the state for review.
OneCare is obligated to provide the documents, the state argued in its filing. The private, for-profit company is under contract with the state to distribute Vermont’s Medicaid money to doctors and hospitals, and the agreement requires that the company submit to state or federal audits.
“When you sign a contract, you have to comply with all the terms, not just ones that you like,” Hoffer said in an interview Wednesday. OneCare has refused to provide the information for more than a year, he said.
“They are not above the law,” Hoffer said. “This is troubling, actually. It’s about nothing more than transparency and accountability.”
OneCare CEO Victoria E. Loner denounced Hoffer’s request as “baseless overreach.”
“It really intrudes upon our employees’ privacy,” she said. “We intend to fight this request.”
OneCare Vermont, an accountable care organization, is responsible for rolling out the state’s all-payer system and changing the way health care is paid for. Vermont is in its fourth year of a five-year effort transition to pay hospitals and doctors a set fee rather than for every procedure.
OneCare is a joint venture established by the University of Vermont Medical Center Inc. and Dartmouth-Hitchcock Medical Center, according to the company’s website. It has more than 60 staff members and an administrative budget of nearly $16 million.
Last year, the company signed a deal with the Vermont Agency of Human Services, agreeing to be responsible for $328 million in health care expenditures, provide data analytics and coordinate care for Vermonters on Medicaid. As part of that contract, the accountable care organization must open its books upon request.
“Agents of the state of Vermont and the federal government shall have access to contractor’s accounting records pertaining to contract … for purposes of review, analysis, inspection, audit and/or reproduction,” the contract reads.
Hoffer and his employees requested the salary information in March 2020 and followed up asking for the records later that month, then again in April and May. OneCare refused.
Loner said the company doesn’t, in fact, have to provide more information to the state.
She maintained the company has already provided the data that the state health care regulators and the Agency of Human Services have asked for and has also applied with the IRS to become a nonprofit. OneCare shared its 2019 salaries with the Green Mountain Care Board — but included only its highest-paid workers and executives, just 12 of the more than 61 employees.
OneCare “very much” values transparency, Loner said. “It’s fairly unfortunate that the state auditor is going to such extremes to understand the salary information of every single one of our employees.”
OneCare’s legal team is reviewing the complaint, Loner said.
Hoffer will release an audit of OneCare in the coming weeks, he said. In July, he published a report questioning whether the company was saving Vermonters money.
The information would help provide the state an accounting of taxpayer spending on the all-payer system and quantify the layers of administration in Vermont’s health care system, according to Hoffer.
“Given the scope and seriousness of OneCare’s mission, transparency is critical to ensure taxpayer dollars are being used effectively,” Donovan said in the release. “OneCare is obligated to provide these records to Auditor Hoffer. Their refusal constitutes a breach of contract.”
Last spring, lawmakers and Agency of Human Services Secretary Michael K. Smith also urged OneCare to be more transparent with taxpayers. Smith also put forward a series of changes to the system in November. OneCare has also had trouble getting doctors and Vermonters to buy into the project. On Tuesday, in a win for the company, Gov. Phil Scott announced that state employees would join OneCare under their existing insurance.
Hoffer has also come under fire in recent weeks. Former State Legislator Oliver Olsen released a critique of Hoffer’s reports, and state Sen. Randy Brock, R-Franklin — himself a former state auditor — accused Hoffer of politicizing the role.
Hoffer maintains he’s just doing his job. The cost of “health care is just too big to ignore,” he said.