Medicaid DID billing records
| Submitted | March 2, 2018 |
| Est. Completion | None |
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Communications
From: Evan Anderson
To Whom It May Concern:
Pursuant to the West Virginia Freedom of Information Act and the West Virginia Open Governmental Proceedings Act, I hereby request the following records:
A copy of all Medicaid claims, in whatever format they exist, from 1/1/2000 through 2017. I expect that any identifying information, or any other information that could be construed as a violation of HIPAA, will be redacted. I am specifically seeking information regarding primary diagnosis (ICD-9 or ICD-10 code), provider (NPI is fine), date or year of service, type of service (i.e., psychotherapy), and amount reimbursed.
The requested documents will be made available to the general public, and this request is not being made for commercial purposes.
In the event that there are fees, I would be grateful if you would inform me of the total charges in advance of fulfilling my request. I would prefer the request filled electronically, by e-mail attachment if available or CD-ROM if not.
Thank you in advance for your anticipated cooperation in this matter. I look forward to receiving your response to this request within 5 business days, as the statute requires.
Sincerely,
Evan Anderson
From: Muckrock Staff
To Whom It May Concern:
Pursuant to the West Virginia Freedom of Information Act and the West Virginia Open Governmental Proceedings Act, I hereby request the following records:
A copy of all Medicaid claims, in whatever format they exist, from 1/1/2000 through 2017. I expect that any identifying information, or any other information that could be construed as a violation of HIPAA, will be redacted. I am specifically seeking information regarding primary diagnosis (ICD-9 or ICD-10 code), provider (NPI is fine), date or year of service, type of service (i.e., psychotherapy), and amount reimbursed.
The requested documents will be made available to the general public, and this request is not being made for commercial purposes.
In the event that there are fees, I would be grateful if you would inform me of the total charges in advance of fulfilling my request. I would prefer the request filled electronically, by e-mail attachment if available or CD-ROM if not.
Thank you in advance for your anticipated cooperation in this matter. I look forward to receiving your response to this request within 5 business days, as the statute requires.
Sincerely,
Evan Anderson
From: Muckrock Staff
To Whom It May Concern:
I wanted to follow up on the following Freedom of Information Act request, copied below, and originally submitted on March 2, 2018. Please let me know when I can expect to receive a response, or if further clarification is needed.
Thanks for your help, and let me know if further clarification is needed.
From: Muckrock Staff
To Whom It May Concern:
I wanted to follow up on the following West Virginia Freedom of Information Act request, copied below, and originally submitted on March 2, 2018. Please let me know when I can expect to receive a response, or if further clarification is needed.
Thanks for your help, and let me know if further clarification is needed.
From: Department of Health and Human Resources
Mr. Anderson,
Please consider this BMS' response to your attached FOIA requests of November, 2017 and January 24, 2018. While this office has previously responded to your repeated FOIA requests, allow me to respond once more. Your initial requests sought records regarding all claims made for Dissociative Identity Disorder. This office reviewed the available data and determined that no distinct record containing that information existed. We further explained that, under West Virginia Law, an agency is not required to prepare and produce ad hoc documents simply to respond to a FOIA request. See Daily Gazette Co., Inc. v. Withrow, 350 S.E.2d 738 (1986). Nothing has changed in this regard.
Following that response, you then requested ALL Medicaid claims filed since the year 2000. This request is hereby necessarily rejected because, even if such a distinct record existed, producing it would be onerous, extremely costly, and unduly burdensome. Additionally, we believe it would violate Federal regulations which prohibit state Medicaid programs from proving such information because of the high level of confidentiality of the information contained in those records. See 42 C.F.R. 431 subpart F.
The responsibilities of this office with respect to your request are now at an end. You are advised that FOIA affords you the opportunity to seek injunctive or declaratory relief in the Circuit Court of Kanawha County. Should you have any questions, feel free to contact me at your earliest convenience. With kind regards, I remain,
Very truly yours,
Riley J. Romeo, Jr., Esq.
Deputy General Counsel
Bureau for Medical Services, Legal Division
350 Capitol Street, Room 251
Charleston, WV 25301
304-558-1700
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From: Evan Anderson
Hi there,
Thanks for the reply. I understand your frustration at my persistence. I am simply wishing to obtain records that I know you are in possession of. The DHHR does possess Medicaid data, correct? You stated that, "[My request for all Medicaid data since 2000] is hereby necessarily rejected because, even if such a distinct record existed, producing it would be onerous, extremely costly, and unduly burdensome." This seems to indicate a rejection of my request because your Medicaid data is not a "distinct" record, which I find questionable.
It is again clear that you don't want to give me the records I am seeking. Every other state that I have filed this request in has simply asked for clarification, and I've happily provided it. Instead, your office has repeatedly abused the "creating a record" and "distinct record" exemptions to prevent transparency. Unless you're working with paper records, there is no reason why you could not a) query your database for the specific data elements I am seeking (which, by the way, is not considered creating a record in the 21st century), or b) export all the data to an excel spreadsheet, and redact all columns containing PHI.
Sincerely,
Evan