Hospitals, Other Providers Request Non-Payment of Nebraska State Health Information Provider Fees.

LINCOLN – The state’s provider of health care information and prescription drug purchases to doctors and hospitals is in jeopardy because the state is unable to pay in full on a $15 million-a-year contract.

The lack of payment to CyncHealth prompted the organization’s board of directors — a group of hospital and health care administrators — to “beg” the Nebraska Department of Health and Human Services to meet its obligations and create a data-sharing network.

DHHS has signed a contract with La Vista-based CyncHealth to provide a statewide Heath Information Exchange (HIE) by documenting a patient’s past treatments and health records in an effort to improve health outcomes. SyncHealth operates a Prescription Drug Monitoring Program (PDMP) that tracks drug purchases to prevent “doctor shopping” of duplicate prescriptions for dangerous opioids like OxyContin.

The lack of payment, according to the September 16 letter, is an example of the government’s poor planning and “impossible unnecessary bureaucracy”.

“If providers fail to obtain an HIE or PDMP that puts the health of Nebraskans at risk, they will be hindered from providing optimal care to their patients,” the letter added. We request you to meet your financial obligations….

A letter signed by the hospital authorities

The letter was signed by 17 SyncHealth board members and representatives of the state’s major health providers, including Nebraska Methodist, CHI Health, Nebraska Medicine and Children’s Hospital, all of which use health data.

Nebraska DHHS spokesman Jeff Powell said in an email Thursday that the federal Medicaid programs that funded 90% to 100% of HIE and prescription drug program costs “changed significantly” last year and in 2018 Some cases are over.

That, Powell said, leaves DHHS without the money to pay SyncHealth in full — about $11 million short — on a $14.6 million contract that runs through the end of September. The contract includes a one-year extension through September 2023 for $18.9 million.

The agency paid SyncHealth for its prescription drug monitoring program through July, but the state has exceeded the $1 million allocated to HIE, he said. Jaime Bland, president and CEO of SyncHealth, estimated at the end of September that the state owed SyncHealth nearly $11 million.

Powell added that DHHS has pledged to seek a deficit from the state Legislature to meet its remaining contractual obligations.

The responses left CyncHealth officials scratching their heads as to why they were not being paid and scrambling to make ends meet.

He was forced to borrow money

Bland said her company has been forced to borrow money to keep paying its 75 employees and has been unable to pay some of its technology suppliers.

The lack of payment has hurt its credit rating, Bland added, and threatened the inability of SyncHealth to continue providing the information to health care providers — providers it says have already paid their bills to help keep the operation afloat.

In August, SyncHealth saw 637,463 records placed on the HIE by healthcare providers. In the past 12 months, the Veterans Administration and Department of Defense reviewed 5 million records provided by the Nebraska HIE nationwide.

Bland said DHHS is aware that federal program changes are coming and the agency could use state allocations to match federal funding through new programs. She said the Legislature won’t be able to consider the deficit until January, which would put SyncHealth even further in the hole.

“What they’re doing doesn’t make sense,” Bland said.

New federal funds

Powell acknowledged that new federal funding options are available to DHHS to pay for electronic health information, but said they do not provide as much in matching funds. He added that the agency has not been able to calculate how much additional state funding is needed to be included in the budget year.

Doctors and hospitals across the state and nation use health information exchanges to track a patient’s past health records and what treatments they’ve received at other facilities.

The prescription drug monitoring program was a priority of former Omaha state Sen. Sarah Howard, whose sister died of a prescription overdose. The idea is to track how often opioids are prescribed and purchased by patients, to stop “doctor shopping” and the ability to access dangerous drugs.

The two programs are funded by a combination of state and federal funds, with some fees paid by health care providers.

State Sen.  John Arch of La Vista
State Sen. John Arch of La Vista (provided by Unicameral Information Office)

La Vista state Sen. John Arch, chairman of the Legislature’s Health and Human Services Committee, which oversees DHHS, said the agency is still trying to resolve federal funding changes that prompted the payment issue.

‘Nothing is easy’

“There’s nothing easy about federal funding,” said Arch, whose district includes the SinkHealth office.

The problems must be solved so that there is a steady source of funding for SyncHealth and the funding is predictable.

Arch, a former health care administrator, called it a “tremendous resource” for both medicine and research to “move the needle” on disease treatment and reduce health care costs.

Arch added that they believe the financial issues will be resolved.

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