Congressional physicians take aim at electronic transfer fees

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Physicians in the House of Representatives are taking aim at fees that chip away at doctors’ revenues.

The new “No Fees for EFTs Act” is the latest bill to join the stack of various health care proposals pending in Congress. The act would protect physicians, other health care providers, and patients from unnecessary fees associated with electronic fund transfers (EFTs) and payment transactions, Rep. Greg Murphy, MD (R-North Carolina), said in an announcement.

"Fees associated with electronic transactions for physician services are an unnecessary and costly burden on providers and patients," Murphy said in the news release. "Greedy health insurers attempt to scalp doctors and patients every step of the way throughout the care process to line their pockets. We don't tolerate paying fees to receive direct deposit of a paycheck, likewise, doctors and patients should not be forced to pay predatory fees on electronic payments on essential health services."

Additional sponsors include Rep. Marianette Miller-Meeks, MD (R-Iowa), and Rep. Kim Schrier, MD (D-Washington), and Ami Bera, MD (D-California). They joined in the announcement with Rep. Derek Kilmer, (D-Washington), with support from the Medical Group Management Association (MGMA) and the American Medical Association (AMA).

How it works

“Under the Affordable Care Act (ACA), health plans are required to offer medical practices the option to receive reimbursements electronically,” Murphy’s announcement said.

When physicians choose electronic reimbursement, insurers then charge fees generally ranging from 2% to 5%. That may not sound like much, but Murphy cited MGMA data showing how the fees add up for insurance companies while detracting from physicians’ practices.

In April this year, a survey of almost 150 medical groups found more than two-thirds use EFT reimbursement for more than 75% of their practice’s annual revenue, according to MGMA.

A majority of practices estimated the fees were $100,000 or less a year, but in some cases estimates climbed as much as $1 million.

In the survey, two-thirds of practices said health insurance companies also are charging fees the physicians did not agree to when sending payment by EFT.

In August, MGMA issued its position paper calling for an end to EFT fees. MGMA noted physicians are not required to use that method, but getting paid by check or virtual credit cards creates another layer of fees and administrative hassles.

Additional responses

Miller-Meeks and Schrier drew on their own experience as physicians in their comments about the bill.

EFT fees is another burden on physicians in underserved and rural areas. The ACA rule is outdated, but the fees “can shutter a practice, by mounting practice cost expenses, especially in a time of high inflation, when reimbursement does not keep pace. Our bill, the 'No Fees for EFTs Act', addresses the deceptive business practices of EFTs and protects a doctor's ability to provide quality patient care," she said.

Doctors don’t get the compensation they deserve when insurers force them to pay fees before getting paid for their services, Schrier said.

“I am proud to continue to be a voice for physicians in the House by introducing this bipartisan legislation in hopes of prohibiting these excessive fees impacting our medical providers at a time when we are experiencing severe doctor shortages nationwide," she said.

MGMA thanked the lawmakers, and AMA President Jesse M. Ehrenfeld, MD, MPH, called the bill “a victory for common sense.”

Kilmer added a statement calling the bill “a crucial step forward” for a more efficient and fair health care system. He noted it is a bipartisan effort.

“These costs not only hinder our medical professionals financially but also divert critical resources away from patient care,” Kilmer said. “This bipartisan effort underscores our commitment to eliminating predatory practices in our health care system and ensuring that every dollar is directed towards improving patient outcomes."