CMS finalizes new regulation to standardize electronic funds transfer

The Centers for Medicare & Medicaid Services (CMS) announced that the interim final rule that adopts healthcare electronic funds transfer (EFT) standards is now a final rule currently in effect. According to CMS, the standards for EFT could reduce administrative costs for physician practices and others by up to $4.5 billion over the next ten years. The rule is the second in a series of regulations mandated by the administrative simplification section of the Affordable Care Act and adopts many of the MGMA recommendations submitted during the public comment period.

The final rule outlines two standards that health plans must comply with in order to use EFT to transmit healthcare claim payments to providers. First, health plans are required to use a standard format when ordering, authorizing or initiating an EFT with their banks. Second, the rule outlines the data content of the EFT.

Health plans and other covered entities must comply with the provisions of the EFT rule by Jan. 1, 2014. However, CMS indicates that health plans are permitted to use the EFT standards with willing trading partners before that date. Practices not already receiving EFT payments should contact their practice management system software vendor and health plans to discuss incorporating this transaction into their claims revenue cycle workflow.

Read the full regulation in the Federal Register.