In an Oct. 16 opinion piece published in MedpageToday, Nehad Soloman, MD, a Glendale, Ariz.-based rheumatologist writes that fees for electronic fund transfers on payments made at medical practices "cut into practices' often razor-thin margins as they struggle to stay afloat after years of stagnating reimbursement."
Here are seven takeaways from the article:
1. The requirement for health insurers to offer physicians standardized electronic payments was initially outlined in the ACA, with the intention of reducing healthcare spending by cutting out the need for checks and receipts to be processed manually. CMS affirmed this in 2017 by prohibiting insurers from charging a fee when they reimbursed physicians for their services electronically.
2. A ProPublica report published in August revealed that CMS' guidance was dropped six months before it was supposed to go into effect after "intense and well-funded lobbying" by the insurance industry.
3. Insurers can now demand an up to 5% fee on every transaction if physicians opt to be paid electronically. Even those who switch back to being paid by check to avoid these fees may eventually be forced into accepting EFT payments and paying the "predatory" fees.
4. One survey cited in the article, conducted by the Medical Group Management Association, found that nearly 60% of responding physician practices reported being forced into paying the fees without ever agreeing to them.
5. MGMA also reported that in two-thirds of physician practices, over 75% of their annual revenue is paid via EFT payments. Larger physician practices may pay up to $1 million in EFT fees annually.
6. Last year, a group of lawmakers in Congress introduced the No Fees for EFTs Act, which would prohibit insurers from imposing EFT fees on physicians and other providers.
7. Dr. Solomon concludes that while support of this bipartisan bill is important, Congress must also "work to reform the Medicare physician payment system to help put physician practices nationwide on solid footing in order to protect patient access to care."