An interim final rule adopting electronic funds transfer (EFT) standards has been finalized announced the Centers for Medicare & Medicaid Services last week.
The rule sets out industry standards for formatting EFTs and remittance advice transactions as part of the administrative simplification provisions of the Affordable Care Act.
It mainly impacts transactions originating with health plans and only applies to the transactions taking place within the Automated Clearing House Network (ACH), which serves as a pipeline of sorts for transmitting data via telecommunications networks nationwide.
The now-finalized rule is a small piece of the overall set of operating rules required by the ACA, said Stuart Hanson, vice president and product line manager for healthcare solutions at Fifth Third Bank.
The Council for Affordable Quality Healthcare Committee on Operating Rules for Information Exchange (CAQH CORE) and its subgroups created and made recommendations for operating rules to HHS last summer. Hanson served as co-chair of the EFT and ERA Operating Rules Subgroup.
"This (final rule) is a pretty simple part of it (the operating rules)," Hanson said, "but I think it is a great foundational rule." The tricky part, he noted, will be the other pieces of the operating rules that have not yet been finalized.
The ACA requires that operating rules be adopted no later than July 1, 2012 and become effective no later than Jan. 1, 2014. Hanson said he expected HHS to make some announcement on the other operating rules at the beginning of this month, given the ACA deadline. He said he doesn't know what has caused HHS' delay. (HHS did not respond to a request for comment.)
The rule finalized last week has been in effect since the interim rule was released in January. Compliance is required by Jan. 1, 2014.
Hanson said that after some initial confusion by payers around how the new rule should be implemented and a wait-and-see attitude regarding whether or not the Supreme Court would uphold or strike down the healthcare law, he thinks everyone is on their way to making the compliance deadline.