The Centers for Medicare & Medicaid Services (CMS) issued guidance to clarify requirements for covered entities conducting transactions using Virtual Credit Cards (VCCs), electronic funds transfer (EFT) and electronic remittance advice (ERA). In the guidance, CMS addresses three specific questions:

1- Do the adopted HIPAA EFT and ERA standards permit health plans to pay claims by VCCs?

2- If a health care provider requests that a health plan pay the provider’s claims using the adopted HIPAA EFT and ERA standards, must the health plan comply?

3- Can a health plan require a provider to agree to receive payment or reassociation services from a vendor of the health plan’s choosing as condition of receiving EFT or ERA using the adopted standards?

We have summarized the answers to these questions from the guidance provided. Use the link below to learn more.