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CMS guidance details provider protections for health plan electronic claims payments

CMS issued guidance clarifying HIPAA protections and responsibilities when health plans issue claims payments using Virtual Credit Cards, HIPAA Electronic Funds Transfers and Remittance Advice transaction standards. According to the guidance, 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.

Published March 25, 2022