Insurers or their vendors are charging physician practices and hospitals fees ranging from 2% to 5% of claims payments for electronic funds transfer transactions.
One of the sponsors of legislation that would end fees for healthcare providers' electronic funds transfer (EFT) transactions from insurers is optimistic about the bill's passage.
In November, the No Fees for EFTs Act (H.R. 6487) was introduced in the U.S. House of Representatives. For years, health insurers and their vendors have been charging physician practices and hospitals fees ranging from 2% to 5% of claims payments in EFT transactions.
The legislation was introduced by U.S. Reps. Greg Murphy, MD, (R-NC), Morgan Griffith (R-VA), Marianette Miller-Meeks, MD (R-IA), Ami Bera, MD (D-CA), Kim Schrier, MD (D-WA), and Derek Kilmer (D-WA).
Rep. Murphy says he expects the legislation to be adopted by the House and the U.S. Senate. "I am optimistic about this legislation passing. There is definitely bipartisan support in the House, and it should pass in the Senate."
The next step for the legislation is review in at least one House committee.
The Affordable Care Act mandated that insurance companies be able to provide an electronic payment for medical services by physicians, physician groups, and hospitals. Insurance companies have been charging EFT transaction fees for "value-added services" such as a customer service phone number.
Murphy says the fees are a "ridiculous charge."
"Some physician groups have been charged up to $1 million annually. It is just absolutely absurd. You shouldn't have to pay a fee to get your own money," he says.
The American Medical Association (AMA) helped draft the No Fees for EFTs Act. The AMA says the EFT fees are equivalent to an employer charging a fee for providing employees with electronic direct deposit payments for compensation.
AMA President Jesse Ehrenfeld, MD, MPH, says the EFT fees are an unnecessary burden for physician practices. "Insurers have slashed reimbursement rates, foisted prior authorization requirements on physicians, and created narrow networks. But requiring physicians to pay fees to get paid? This bill would give much needed relief to physician practices and score a victory for common sense," he said in a prepared statement.
Murphy says EFT fees are an existential threat for many physician practices and hospitals.
"I ran a surgical practice for many years. We had five surgeons in a poor area of the country, so our margins were very thin," he says. "If you add a surtax of 2% to 5% on an already thin margin, it further decreases your ability to survive financially. If you don't survive financially, you either close the doors or get acquired by a hospital, which is a more expensive site of care. These fees are a threat to keeping private practices and hospitals in business."
EFT payments were supposed to make claims payments easier, so healthcare providers did not have to process paper checks, which is burdensome and has the possibility of lost checks, the AMA says. The point of EFT transactions was saving money and improving efficiency for payment transactions in the healthcare system—it was not supposed to be a revenue-generator for anyone, the AMA says.
Christopher Cheney is the senior clinical care editor at HealthLeaders.
The No Fees for EFTs Act was introduced in the U.S. House of Representatives in November.
The American Medical Association says charging healthcare providers fees for electronic claims payments are equivalent to an employer charging a fee for providing employees with direct deposit payments.
The No Fees for EFTs Act has bipartisan support in the U.S. House of Representatives.