Johansson, Carol v. Executive Office of Health & Human Services (SPR 20260975)

The Commonwealth of Massachusetts William Francis Galvin, Secretary of the Commonwealth Public Records Division Manza Arthur Supervisor of Records March 30, 2026 SPR26/0975 Berlinda Bernard Records Access Officer Executive Office of Health and Human Services One Ashburton Place, Room 1109 Boston, MA 02108 Dear Ms. Bernard: I have received the petition of Carol Johansson appealing the response of the Executive Office of Health and Human Services (Office/EOHHS) to a request for public records. See G. L. c. 66, § 10A; see also 950 C.M.R. 32.08(1). On September 30, 2025, Ms. Johansson requested the following: 1. Internal EOHHS Escalation Pathway: All policies, procedures, and organizational charts that define the formal internal EOHHS escalation pathway for a MassHealth beneficiary grievance, particularly in a circumstance where the matter has been addressed, or has failed to be addressed, by both the contracted Third-Party Administrator (TSA) and the designated oversight level within EOHHS. This request specifically seeks to identify the next level of internal administrative appeal or review available to a beneficiary, including the title, office, and authority to which such an escalation is directed. 2. External State-Level Oversight of EOHHS: All policies, procedures, and guidance documents that identify the external, statewide oversight bodies with statutory authority over the Executive Office of Health and Human Services (EOHHS). This request includes the formal process for a beneficiary to file a complaint with these bodies regarding systemic administrative failures, a lack of due process, and a failure by EOHHS to properly manage its contractors. 3. External Federal-Level Oversight: All policies, procedures, and guidance documents that identify the external federal agencies with statutory oversight authority over the administration of the Massachusetts Medicaid program. This request specifically seeks the formal process for filing a complaint with these federal bodies regarding the state’s failure to comply with federally mandated 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

Berlinda Bernard SPR26/0975 Page 2 March 30, 2026 grievance, appeal, and due process standards. CLARIFICATION: For the avoidance of doubt, this request is for records pertaining to the procedural oversight and escalation of the grievance process itself. It is not a request for a substantive review of any specific benefit determination. The Office responded on October 15, and October 22, 2025. Unsatisfied with the Office’s responses, Ms. Johansson petitioned this office, and this appeal, SPR26/0975, 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. Attorney 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 Office’s October 15th and October 22nd Response In its October 15, 2025 response, the Office states that it “continues to process your request to gather potentially responsive records.” In its October 22, 2025 response, the Office states the following: EOHHS has reviewed your recent public records request regarding MassHealth Dental Grievance Escalation Procedures. EOHHS previously provided responsive records to your April 2025 request on this same topic. The records previously produced on May 1 4, 2025, remain complete and responsive. EOHHS now considers your request closed.

Berlinda Bernard SPR26/0975 Page 3 March 30, 2026 Current Appeal In her appeal petition, among other things, Ms. Johansson argues the following: [D]ocumentation identifying the internal escalation pathways, the titles of oversight officials, and the methods for external state and federal review (Categories 1, 2, and 3 of the Request) are records that EOHHS is federally mandated to maintain. These documents constitute public records as defined by G.L. c. 4, § 7(26) and are in the possession, custody, and control of EOHHS. . . . EOHHS has not identified any countervailing interest or statutory exemption that would justify withholding information concerning internal escalation procedures, external state-level oversight bodies, or external federal-level oversight agencies. The public interest is particularly acute where the records concern the oversight of a state contractor, BeneCare, which has been terminated for documented operational deficiencies. . . . The September 30, 2025 public records request seeks records that are distinct from those requested on April 18, 2025. EOHHS has not met its burden of proof to justify the withholding of these records, nor has EOHHS identified any statutory exemption under G.L. c. 4, § 7(26) permitting such a denial. Furthermore, the procedural history of this matter indicates a coordinated administrative effort to discourage the pursuit of these records. Records in Existence; Possession, Custody, or Control Please be advised 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 32 Op. Att’y Gen. 157, 165 (May 18, 1977). However, in accordance with the Public Records Law, custodians are expected to use their superior knowledge of the records in their custody to assist requestors in obtaining the desired information. See 950 C.M.R. 32.04(5). Based on the Office’s responses, and the information provided in Ms. Johansson’s appeal petition, it is unclear whether the Office possesses additional records responsive to the request. If the Office does possess additional responsive records, it must either provide the records, or cite an exemption to the Public Records Law, and explain with specificity how such an exemption applies to withhold or redact the records. See G. L. c. 66, § 10(b)(iv) (a written response must “identify any records, categories of records or portions of records that the agency or municipality intends to withhold, and provide the specific reasons for such withholding, including the specific exemption or exemptions upon which the withholding is based”).

Berlinda Bernard SPR26/0975 Page 4 March 30, 2026 Conclusion Accordingly, the Office is ordered to provide Ms. Johansson with a response to the request, provided in a manner consistent with this order, the Public Records Law and its Regulations within ten (10) business days. A copy of any such response must be provided to this office. It is preferable to send an electronic copy of the response to this office at pre@sec.state.ma.us. Ms. Johansson may further appeal the substantive nature of the Office’s response within ninety (90) days. See 950 C.M.R. 32.08(1). Sincerely, Manza Arthur Supervisor of Records cc: Carol Johansson