ASCP joined with the AMA and other medical societies to raise concern
in a letter to the Centers for Medicare & Medicaid Services about unfair business practices by health plans related to electronic payments for health care services. ASCP and others are asking CMS to clarify and enforce the right of pathologists and other physicians to receive electronic payments via the Automated Clearing House electronic funds transfer (EFT) standard
without being forced to pay percentage-based fees for so-called “value-added” services.
A recent poll by the Medical Group Management Association found that 57 percent of medical practices surveyed reported that health plans charge fees that the practice has not agreed to when sending payments via the EFT standard, with 86 percent reporting average fees of 2 percent to 3 percent associated with each claim. These fees are most often assessed by third-party vendors with which health plans require physicians to contract for EFT payment processing.
CMS has failed to provide clear guidance on this issue, enabling the imposition of inappropriate fees on electronic payments. ASCP and other signers of the joint letter are seeking guidance from the agency that affirms physicians’ right to choose and receive basic EFT payments without paying for these services coupled with agency enforcement of the guidance.
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