Nancy McGovern v. Massachusetts Strategic Health Group (SPR 20252237)

The Commonwealth of Massachusetts William Francis Galvin, Secretary of the Commonwealth Public Records Division Manza Arthur Supervisor of Records August 13, 2025 SPR25/2237 Richard LaFond Board Chair Mass Strategic Health Group 1500 West Park Dr., Suite 330 Westborough, MA 01581 Dear Mr. LaFond: I have received the petition of Nancy McGovern appealing the response of the Massachusetts Strategic Health Group (Group) to a request for public records. See G. L. c. 66, § 10A; see also 950 C.M.R. 32.08(1). On June 30, 2025, Ms. McGovern requested: [1] The current constitution / by-laws of the MSHG. [2] A copy of the detailed contract between MSHG and NFP. This shall include any/all fees paid to the NFP, detailed services provided by NFP. Further, provide the actual annual payments and commission fees to NFP from each insurance plans including, but not limited to, medical plans, dental, and Medicare through Aetna. [3] The name of all consultant/broker/advisors for each municipality who are under MSHG including any/all fees paid to them. [4] A copy of any/all contracts or agreements between MSHG to vendors outside of NFP. For example, PBMs, Stop-Loss Insurance, ASO, Health and Wellness, etc. this shall include the annual costs by MSHG to each vendor. [5] It has come to our knowledge that MSHG is in deficit with limited ability to make payments for claims paid in the month of June and July. Provide an actual number of deficit and how MSHG has selected to compensate money owed to carriers for claims. This shall include, but not limited to, how MSGH [sic] has chosen to pay outstanding money owed to HPI. [6] It has come to our attention that NFP may be recommending that money One Ashburton Place, Room 1719, Boston, Massachusetts 02108 • (617) 727-2832 • Fax: (617) 727-5914 sec.state.ma.us/pre • pre@sec.state.ma.us

Richard LaFond SPR25/2237 Page 2 August 13, 2024 contributed for the Aetna Medicare plans shall be transferred to make payments to non-medicare money owed. Please confirm if this is occurring and if so, provide details and under what law allows this to occur. [7] Any consideration by MSHG to focus on the collapsing of Aetna availability and cost changes. [8] When the RCA/CPA FY24’ and FY25’ audits are completed, we request you send this to us as well. The Group provided a response on July 11, 2025. Unsatisfied with the Group’s response, Ms. McGovern petitioned this office and this appeal, SPR25/2237, was opened as a result. The Public Records Law The Public Records Law strongly favors disclosure by creating a presumption that all governmental records are public records. G. L. c. 66, § 10A(d); 950 C.M.R. 32.03(4). “Public records” is broadly defined to include all documentary materials or data, regardless of physical form or characteristics, made or received by any officer or employee of any agency or municipality of the Commonwealth, unless falling within a statutory exemption. G. L. c. 4, § 7(26). It is the burden of the records custodian to demonstrate the application of an exemption in order to withhold a requested record. G. L. c. 66, § 10(b)(iv); 950 C.M.R. 32.06(3); see also Dist. Att’y for the Norfolk Dist. v. Flatley, 419 Mass. 507, 511 (1995) (custodian has the burden of establishing the applicability of an exemption). To meet the specificity requirement a custodian must not only cite an exemption, but must also state why the exemption applies to the withheld or redacted portion of the responsive record. If there are any fees associated with a response a written, good faith estimate must be provided. G. L. c. 66, § 10(b)(viii); see also 950 C.M.R. 32.07(2). Once fees are paid, a records custodian must provide the responsive records. The Group’s July 11th response In its July 11, 2025 response, the Group provided some records responsive to the request and stated: [1] Enclosed is a copy of the Massachusetts Strategic Health Group Agreement for Joint Negotiation and Purchase of Certain Insurance Coverages Amended and Restated Effective July 1, 2023. [2] Enclosed is a copy of the Engagement of Services Agreement between NFP and the MSHG.

Richard LaFond SPR25/2237 Page 3 August 13, 2024 [3] The MSHG does not have a document responsive to this request. [4] Enclosed are documents responsive to this request. [5] The MSHG does not have a document responsive to this request. The public records law does not require the MSHG to answer questions. Its unwillingness to do so voluntarily is not a concession that anything you write is accurate. [6] The MSHG does not have a document responsive to this request. The public records law does not require the MSHG to answer questions. Its unwillingness to do so voluntarily is not a concession that anything you write is accurate. [7] The MSHG does not have a document responsive to this request. The public records law does not require the MSHG to answer questions. Its unwillingness to do so voluntarily is not a concession that anything you write is accurate. [8] The MSHG does not currently have any document(s) responsive to this request. It is not obligated under the public records law to keep this request on file until document(s) fitting this description comes into existence. Current Appeal In her appeal to this office, Ms. McGovern stated: We are appealing the response to questions 5-8 where they indicate it is not subject to the public records law. As you will see from the Trust document they are formed under MGL32b section 12. The Mass Strategic Health Group consists of multiple municipal units that provide health benefits to public employees and public retirees. The information requested is aggregate, not individual as we are aware of HIPPA laws and others that protect individual health data. We regularly request this information to complete analysis and provide information to members relative to their health benefits. No Duty to Create Records Please note that the duty to comply with requests for records extends to those records that exist and are in the possession, custody, or control of the custodian of records at the time of the request. See G. L. c. 66, § 10(a)(ii). Further, under the Public Records Law, a public employee is not required to answer questions, or do research, or create documents in response to questions. See G. L. c. 66, § 10(a); 32 Op. Att’y Gen. 157, 165 (May 18, 1977). Additionally, the Public Records Law does not require a custodian to honor a prospective request. In a telephone call between a staff attorney of the Public Records Division and the Group on August 7, 2025, the Group confirmed that it searched for and has found no additional responsive records to Ms. McGovern’s request.

Richard LaFond SPR25/2237 Page 4 August 13, 2024 Conclusion Where the Group confirmed that it does not possess additional records responsive to Ms. McGovern’s request, and has no duty to create records responsive to the request, I will now consider this administrative appeal closed. If Ms. McGovern is not satisfied with the resolution of this administrative appeal, please be advised that this office shares jurisdiction with the Superior Court of the Commonwealth. See G. L. c. 66, §§ 10(b)(ix), 10A(c) (pursuing administrative appeal does not limit availability of judicial remedies). Sincerely, Manza Arthur Supervisor of Records cc: Nancy McGovern