MGMA Urges CMS To Issue Additional Guidance on EFT Transfers

June 23, 2014 in News

In a letter to CMS Administrator Marilyn Tavenner, the Medical Group Management Association asks CMS to take action on some health insurer payment practices, Health Data Management reports.

MGMA urges CMS to stop health plans from charging excessive fees for paying claims through electronic funds transfer transactions. Payment via EFT transaction is mandated by HIPAA.

The group’s letter also calls on CMS to stop health plans and financial institutions from improperly using so-called “virtual” credit cards to provide reimbursements.

Specifically, MGMA asks CMS to issue guidance stating:

  • A clear definition of “excessive fees” for EFT transactions;
  • That credit cards, virtual or otherwise, do not meet ACA requirements for reimbursements from health plans; and
  • That health plans and claims clearinghouses cannot require providers to accept virtual credit card payments in place of EFT transactions (Goedert, Health Data Management, 6/23).

The association notes that fees in excess of 13 cents to 34 cents per transaction — the typical amount for health plans and clearinghouses — “will result in providers not transitioning to EFT and the industry not realizing the significant efficiencies associated with this transaction” (MGMA letter, 6/11).

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