CMS Issues Updated FAQs Around Healthcare EFTs

In response to healthcare provider questions around the use of virtual cards and fees that can be charged for the healthcare EFT standard, the Centers for Medicare & Medicaid Services (CMS) updated its FAQs to address these questions. According to CMS, the use of virtual cards for claims payments covered by HIPAA transactions is not a requirement. HHS adopted Electronic Funds Transfer (EFT) standards that apply only to health care claim payments made via EFT through the Automated Clearinghouse (ACH) Network. Virtual credit card payments are made outside of the ACH Network and therefore are not covered by the HIPAA EFT standards. The ACH Network, which is administered by the National Automated Clearing House Association (NACHA), is the processing and delivery system for many EFT. If a provider requests to receive health care claim payments via EFT through the ACH Network, a health plan must comply with that request. Health plans should not charge providers communications fees for the use of the HIPAA EFT transaction, nor should health plans’ payment vendors, which are business associates of the health plans, do so. Any fees charged to a provider for an EFT transaction are banking transaction fees, which should be applied only by the provider’s financial institution. According to NACHA, these fees are typically around $.034 per transaction nationally. This amount is current as of 2017 information. 

For more from CMS on healthcare EFTs, visit the CMS Frequently Asked Questions page.