August 11, 2021
The Honorable Chiquita Brooks-LaSure
Administrator Centers for Medicare & Medicaid Services
Department of Health and Human Services
200 Independence Avenue, SW Washington, DC 20201
Re: CMS’ authority to prohibit EFT fees in healthcare
Dear Administrator Brooks-LaSure,
On behalf of our member medical group practices, the Medical Group Management Association (MGMA) writes today regarding the growing incidence of fees being levied upon medical groups by health plans and their payment processing vendors to receive electronic reimbursements through electronic funds transfer (EFT). We believe this increase is partially a result of the void created by CMS beginning in 2017 when it removed clear and unambiguous guidance from its website prohibiting health plans and their payment processing vendors from engaging in abusive business practices that run counter to an efficient healthcare system. Sections 1172 (b) and 1173 (a)(1) of the Social Security Act direct the Secretary to establish standards for certain transactions to, among other goals, improve the operation of the health care system and reduce administrative costs of providing and paying for health care. Given that CMS has a both a statutory requirement and the authority to prohibit EFT fees, the industry guidance removed by the prior administration in 2017 should be reposted or clearly restated by CMS in a definitive manner. If CMS will not provide clear guidance, we ask the agency to expeditiously and clearly state why it is not using its legal authority to prohibit these abuses.