As reported in the last Bulletin, the North Carolina Medical Society (NCMS) 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. The complaint is part of NCMS’s efforts to end unfair policies that require doctors to accept credit card payments from insurers.

CMS responded in a letter dated January 31, that our complaint appears valid.  CMS is requesting that Integra respond to our asssertion that the company is not complying with 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.

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.

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.