NCMS has filed a complaint with the Centers for Medicare and Medicaid Services (CMS) against Integra Employer Health, a benefit management company that processes claims and payments on behalf of self-insured health plans. Our complaint asks CMS to enforce the new federal electronic fund transfer (EFT) and electronic remittance advice (ERA) rule, which took effect on January 1, 2014. The rule now requires all HIPAA-covered health plans to offer payments via EFT-ACH (also known as “direct deposit”) to all providers who request it.
Despite this new rule, Integra continues to enforce a rigid policy whereby a “virtual” credit card is the only available payment methodology for services rendered. Integra routinely cites the policy when refusing physician requests to be paid via EFT. Of course, a practice that accepts these credit card payments must also incur the credit card company’s transaction charges – resulting in payment reductions that were likely never anticipated.
The NCMS filed this complaint on behalf of all members who may have encountered refusals when requesting EFT payments in violation of the new rule. The complaint is currently under investigation.
Watch the Bulletin for updates on the investigation and outcome. For more information on the new rule and how to request EFT payments, visit the CAQH Committee on Operating Rules for Information Exchange (CORE) website. The AMA also offers a toolkit outlining the benefits of EFT and how to access them.