The HMOs adamantly resist disclosing how much money they pay certain specialists, like cardiologists. And lawyers like Sheldon Toubman of Greater New Haven Legal Aid think the Department of Social Services drags its feet in forcing the HMO's to turn over the goods.

Now, according documents released yesterday (prompted by an order from the governor's office), Community Health Network President Sylvia Kelly explicitly warned DSS last month that disclosing the information would result in "substantial increases in the premium rates paid by DSS for the Medicaid managed care programs."

Translation: Give up the info, and it will cost you.

Toubman calls the HMO's statement a threat, meant to cower DSS and make it resist disclosure. And in his view, DSS's decision to release documents yesterday doesn't fulfill their responsibilities under FOI law. The commission hearing today revolved around whether DSS pared down Toubman's request for information when the department forwarded it to the HMOs.

(Click here to read more about how to keep HMOs accountable.)

The department also supports the HMOs' position that they are exempt from FOI law.

But DSS brass heatedly rejects the idea that they have been running interference for the HMO's. DSS Deputy Commissioner Michael Starkowski said that Kelly's statement about higher costs to the state "has no relationship to the decisions we made" to release the documents yesterday, because the governor made a policy choice in favor of disclosure.

"The overriding decision is that it's the public's right to know," Starkowski said. "At the end of the day, the public's right to know and release of information may have consequences on the rate structure on the plan."

Why do the HMOs think disclosure will hurt their bottom line? And why would it then cost the state?

Community Health Network pays some specialists more than others, according to Kelly's letter to Starkowski. Without those favored specialists participating in the network, the HMO wouldn't be able to fulfill its access requirements, they claim, so they pay those docs more in order to participate.

If those rate discrepancies become public, CHN fears doctors will hold out for the rate the insurer pays to those favored few. CHN wouldn't be able to negotiate, and the system will cost them more.

The company's ability to hold down rates "is critical to its ability to provide needed services within the budget dictated by the premium rates it now receives from DSS," Kelly wrote.

The state is currently renegotiating its contracts with the HMOs. Starkowski believes that the HMOs could potentially argue this line, meaning the legislature might have to appropriate more money.

"The legislature would be on notice," Starkowski said.

Toubman doesn't buy the company's argument. Doctors currently have no ability to negotiate rates, he said, and that wouldn't likely change even if they knew what other doctors get paid.

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Click here and here for previous Independent stories on this subject.