Congressional Physicians Introduce Anti-EFT Bipartisan Legislation

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Taking aim at fees that chip away at doctors’ revenues, the No Fees for EFTs Act was presented to Congress in late 2023. 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-NC), said in a press announcement.¹

“Fees associated with electronic transactions for physician services are an unnecessary and costly burden on providers and patients,” Murphy said. “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.”

Rep Mariannette Miller-Meeks, MD (R-IA); Rep Kim Schrier, MD (D-WA); and Rep Ami Bera, MD (D-CA), are additional sponsors. They joined in the announcement with Rep Derek Kilmer, (D-WA), with support from the Medical Group Management Association (MGMA) and the American Medical Association (AMA).

“Under the Affordable Care Act [ACA], health plans are required to offer medical practices the option to receive reimbursements electronically,” Murphy’s announcement explained. Unfortunately, insurers charge fees when physicians choose electronic reimbursement, generally ranging from 2% to 5%. That may not sound like much, but Murphy cited MGMA “data, detailing how the fees add up for insurance companies while detracting from physicians’ practices.”

For instance, an April 2023 survey of approximately 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 per year, but in some cases, estimates climbed as much as $1 million.

These EFT fees are another burden on physicians in underserved and rural areas. According to the survey, two-thirds of practices also said health insurance companies are charging fees the physicians did not agree to when sending payment by EFT.

MGMA has a long-standing position against the EFT fees, issuing a statement in August 2021.² MGMA noted that 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.

Miller-Meeks and Schrier drew on their own experience as physicians in their comments about the bill. 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,” Miller-Meeks said. “The No Fees for EFTs Act addresses the deceptive business practices of EFTs and protects a doctor’s ability to provide quality patient care.”

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

References

1. Murphy introduces bipartisan legislation to eliminate costly health care fees. Press release. US Congressman Gregory F. Murphy, MD. November 28, 2023. Accessed December 6, 2023. https://murphy.house.gov/media/press-releases/murphy-introduces-bipartisan-legislation-eliminate-costly-health-care-fees

2. MGMA calls for prohibition on insurers charging EFT fees. Press release. Medical Group Management Association. August 13, 2021. Accessed December 6, 2023. https://www.mgma.com/press-statements/august-13-2021-mgma-calls-for-prohibition-on-insurers-charging-eft-fees

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