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HomeMy WebLinkAbout85-522 SettinoMs. Anita M. Settino 253 South 4th Street Steelton, PA 17113 Dear Ms. Settino: STATE ETHICS COMMISSION 308 FINANCE BUILDING P.O. BOX 11470 HARRISBURG, PA 1 71 08 -1 470 TELEPHONE (717) 783 -1610 March 12, 1985 ADVICE OF COUNSEL 85 -522 Re: Department of Public Welfare, Office of Medical Assistance, Provider Relations; Spouse Provider This responds to your letter of January 16, 1985, wherein you request the advice of the State Ethics Commission. Issue: Whether there is any conflict of interest under the State Ethics Act if you are employed in the Department of Public Welfare, Office of Medical Assistance, Bureau of Provider Relations, at the same time that your spouse is a participating provider. Facts: You have indicated that you will be assuming a new position in the Pennsylvania Department of Public Welfare. You are currently employed as an income maintenace worker in the Department but you will begin new duties as a medical assistance program technician in the Department's Office of Medical Assistance /Bureau of Provider Relations, hereinafter, the Bureau. You have also indicated that your husband, a dentist, is currently on the Department's provider list as a participating dentist. As such, he has or will utilized the services of the Bureau. You ask whether there is any conflict of interest presented by this situation and what, if any, prohibitions may be placed upon you under the State Ethics Act. In issuing this advice we have reviewed the job description for the position of medical assistance program technician and have incorporated that document herein by reference. Your duties and responsibilities in this position include the following: Responding to inquiries from providers related to billing and payment. Researching appropriate documents for payment or billing information. Ms. Anita Settino March 12, 1985 Page 2 Correcting pended or rejected claims by including additional or accurate information. Research and explain status; adjustments and actions on claims. Explaining, rules, procedures and regulations of the Office of Medical Assistance. Discussion: Initially, it must be n «ot that the jurisdiction of the State Ethics Commission is limited to determinations of an individual's duties and obligations under the State Ethics Apt. As such, the Commission may not address the question presented herein, under any other code of conduct, statute, rule or regulation. For the purposes of this advice we will assume that you are a public employee as that term is defined in the State Ethics Act, and, therefore, subject to the requirements imposed, thereby. 65 P.S. §402. Generally, the State Ethics Act contains no provisions and the Ethics Commission has made no rulings indicating that the situation involved herein would present any inherent incompatibility. The Act does provide that: Section 3. Restricted activities. (a) No public official or public employee shall use his public office or any confidential information received through his holding public office to obtain financial gain other than compensation provided by law for himself, a member of his immediate family, or a business with which he is associated. 65 P.S. 403(a). A member of one's immediate family is defined in the Ethics Act so as to include a spouse residing in one's household. 65 P.S. §402. Thus, in this respect you may not, in your new position, engage in any activity that would be in violation of this Section. That is, you may not use your official position or any confidential information acquired therein to obtain any financial gain either for yourself or for your husband in his current position. While we realize that your husband will be receiving financial gain through the Bureau, this gain is compensation provided for by law in that your spouse, as a participating provider, renders dental services and is, therefore, entitled to reimbursement pursuant to Law. 62 P.S. §443.6(5). Ms. Anita Settino March 12, 1985 Page 3 In addition to the foregoing, however, the State Ethics Commission is empowered to address other areas of possible conflict as they arise. 65 P.S. §403(d). In this respect, as a public employee, you must, avoid a conflict of interest as well as any appearance of such a conflict. The Commission has ruled on numerous occasions that a public official or employee may not, in light of the above requirements, approve or otherwise review the work, or claims of a spouse. See Geary, 84 -568; fetweiler, 81 -648; Wheeler /Williams, 85 -518. Such activity could present or involve an actual conflict of interest or the apearance thereof. In the current situation you are in part responsible for processing bill and payment inquires, as well as ammending claims submitted by providers when necessary. Your husband is a provider submitting such claims and insofar as you personally process or deal with such claims, a conflict may be presented. That is not to say that there is any prohibition in your employment in this new position. The provision of the Ethics Act would only require that you abstain or otherwise not participate, personally process, or make any recommendations for action in relation to a claim, bill or payment regarding your spouse. In this way you will avoid both a conflict and the appearance thereof. Finally, we believe that the Ethics Act places no prohibition upon your providing advice to your spouse regarding the rules, regulations and procedures of the office and /or Bureau, as long as such advice is available generally to all providers and does not involve the actual payment, adjustment or settlement of any bill or claim. Conclusion: The Ethics Act places no prohibition on your acceptance of a position as a medical assistance program technician at the same time your spouse is a participating provider. Your activities, however, must comply with the requirements of the Ethics Act as set forth above. Pursuant to Section 7(9)(ii), this Advice is a complete defense in any enforcement proceeding initiated by the Commission, and evidence of good faith conduct in any other civil or criminal proceeding, providing the requestor has disclosed truthfully all the material facts and committed the acts complained of in reliance on the Advice given. This letter is a public record and will be made available as such. Ms. Anita Settino March 12, 1985 Page 4 Finally, if you disagree with this Advice or if you have any reason to challenge same, you may request that the full Commission rev this Advice. A personal appearance before the Commission will be scheduled and a formal Opinion from the Commission will be issued. Any such appeal must be made, in writing, to the Commission within 15 days of service of this Advice pursuant to 51 Pa. Code 2.12. JJC /sfd Si nce ely, John J. ntino General Counsel