Why doctors pay millions in fees that could be spent on care

Health insurers are increasingly imposing electronic payment fees on doctors, totalling at billions of dollars annually that could be spent on patient care.

Context: The electronic payment system was promoted by the Affordable Care Act in 2010, with the aim of reducing costs.
* Direct deposits require less labor for doctors and insurers compared to paper checks.
* In 2012, the Centers for Medicare & Medicaid Services (CMS) predicted that shifting from paper to electronic billing would save $3 billion to $4.5 billion over 10 years.

Fee Controversy: Despite prohibitions against charging fees, middlemen processing these electronic payments have extracted fees, often sharing them with insurers.
* In 2017, CMS issued a reminder against charging fees with electronic payments, but removed it six months later after protests from industry representatives.
* Doctors often must agree to a fee ranging between 1.5% to 5% to receive electronic payments.

Lobbyist Involvement: One industry lobbyist, Matthew Albright, succeeded in getting CMS to drop the ban on electronic payment fees.
* Albright, who once worked at CMS and was the chief author of the electronic payment rule, later worked for Zelis, a major electronic payment processor.
* He argued the rule was not applicable because it involved middlemen like Zelis.

Effect on Doctors: These fees have become an increasing burden for doctors, some of whom may pass these costs on to patients.
* If unwilling to pay the electronic payment fees, some doctors like New York urologist Alex Shteynshlyuger, revert to less efficient paper checks.

View original article on NPR

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