Advisory Opinion No. 96-67

Re: Richard A. Reuter, D.P.M.

QUESTION PRESENTED

Whether the Code of Ethics permits a member of the Rhode Island Ethics Commission, a state appointed official, to perform utilization reviews concerning the payment of Medicaid benefits under a contract awarded by the Department of Human Services to Connecticut PRO and the Rhode Island Quality Partners.

RESPONSE

The Code of Ethics prohibits a public official from having any interest, financial or otherwise, direct or indirect, or engaging in any business, employment, transaction or professional activity which is in substantial conflict with the proper discharge of his or her duties or employment in the public interest. R.I. Gen. Laws § 36-14-5(a). The Code also provides that a public official shall not accept other employment which will impair his or her independence of judgment as to his or her official duties or employment or require him or her or induce him or her to disclose confidential information obtained during the course of and by reason of his or her official duties. R.I. Gen. Laws § 36-14-5(b). Also, R.I. Gen. Laws § 36-14-8(f)(4) prohibits a member of the Ethics Commission from directly or indirectly attempting to influence any decision by a governmental body, other than as the duly authorized representative of the Commission, on a matter within the jurisdiction of the Commission.

In this matter, the Petitioner, an appointed member of the Ethics Commission, is seeking guidance as to whether the Code of Ethics permits him to do review work for compensation for the Rhode Island Quality Partners concerning the payment of Medicaid benefits on a contract with the Department of Human Services. Given that the Petitioner is conducting an impartial review of medical services provided to Medicaid patients and is not a paid advocate and that neither he nor the Rhode Island Quality partners will attempt to influence the decision making of any governmental body, we conclude that no violation of R.I. Gen. Laws § 36-14-8(f)(4) will occur. See A.O. 93-23 (finding that the furnishing of impartial medical reports to the Workers' Compensation Court of activity is not the type of activity which represents a direct or indirect attempt to influence a decision by a governmental body otherwise prohibited by R.I. Gen. Laws § 36-14-8(f)(4)). Additionally, there is no evidence that providing impartial reviews will create an interest in substantial conflict with his public duties or impair his independence of judgment as to his official duties, thereby triggering the prohibitions set forth in R.I. Gen. Laws §§ 5(a) and (b).

However, we caution and advise the Petitioner that in the event his duality of status should ever impair his independence of judgment or implicate the provisions of Section 5(a), he should (a) notify the Ethics Commission and the Department of Human Services of his interest in the matter at issue and (b) recuse from any participation in connection with that matter. Notice of any recusal should

Code Citations:

36-14-5(a)

36-14-5(b)

36-14-5(f)(4)

Related Advisory Opinions:

94-18 (Amended)

93-23

Keywords:

prospective employment