CMS guidance details provider protections for health plan electronic claims payments

The Centers for Medicare & Medicaid Services yesterday issued guidance to clarify HIPAA protections and responsibilities when health plans issue claims payments using Virtual Credit Cards, and HIPAA Electronic Funds Transfers and Remittance Advice transaction standards. According to the guidance, health plans may use VCCs for claims payments but must use the EFT standard if the provider requests, and a plan cannot require providers to receive EFT payments or reassociation services from its selected vendor. Many plans have required providers to enroll in costly vendor contracts to receive claims payments.