Missouri Gov. Jay Nixon has made a line item veto of $500,000 from the state budget that would have funded connections between the state's Department of Social Services and its health information exchange, Missouri Health Connection (MHC), according to a report from St. Louis Public Radio.
The budget would have provided the funding for connections between the department and MHC to connect long-term care and behavioral health services for access to Medicaid data streams, as long as the funding for the HIE services included direct connections for the purpose of bi-directional HIE of claims and clinical data, and all health information organizations providing services to Tier One safety net hospitals in Missouri.
Evidently, Nixon was concerned with the provision of the bill that no entity receiving the data pursuant to this provision would charge the department for receipt and distribution, nor would the department pay any entity for receiving it, which was construed as meaning that these providers would receive the data at no charge.
"The language added places conditions on health information exchange services that would unfairly exempt [some] providers from the requirement to pay for such services as called for under existing contracts," Nixon said, according to the article.
Neither the bill nor the article specially addressed the legislation's likely intent, which was to increase care coordination among providers, particularly those with some of the most vulnerable patients and who have been excluded from receiving incentive payments or support to adopt EHRs and exchange data electronically.
The lack of funding, moreover, could be yet another indication of the obstacles facing nonprofit, public HIEs to provide accurate and comprehensive data on patients and to compete against private enterprise HIE models.