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.
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