EFT allows for claim payments to be electronically transferred to a provider's bank in place of a hardcopy check mailed to the facility. Medicare payments due a provider or supplier of services may be sent to a bank (or similar financial institution) for deposit in the provider/supplier's account so long as the following requirements are met:

The bank may provide financing to the provider/supplier, as long as the bank states in writing, in the loan agreement, that it waives its right of offset. Therefore, the bank may have a lending relationship with the provider/supplier and may also be the depository for Medicare receivables; and

The account is in the provider/supplier's name only and only the provider/supplier may issue any instructions on that account. The bank shall be bound by only the provider/supplier's instructions. No other agreement that the provider/supplier has with a third party shall have any influence on the account. In other words, if a bank is under a standing order from the provider/supplier to transfer funds from the provider/supplier's account to the account of a financing entity in the same or another bank and the provider/supplier rescinds that order, the bank honors this rescission notwithstanding the fact that it is a breach of the provider/supplier's agreement with the financing entity.

Irrespective of the language in any agreement a provider/supplier has with a third party that is providing financing, that third party cannot purchase the provider/supplier's Medicare receivables.

Requirements for Electronic Funds Transfer and other payment arrangements can be found in the Claims Processing Manual, CMS Pub. 100-4, chapter 1, sections 30.2.5 and 30.2.14.

The Medicare law prohibits us from paying benefits due a provider to another person or organization under an assignment, power of attorney, or any other arrangement whereby that other person or organization receives those payments directly. There are the following exceptions to this rule:

CMS may pay a provider's benefits (in the provider's name) to a billing or collection agent, if:

• The agent receives the payment under an agency agreement with the provider;
• The agent's compensation is not related in any way to the dollar amounts billed or collected;
• The agent's compensation is not dependent upon the actual collection of payment;
• The agent acts under instructions which the provider may modify or revoke at any time; and
• The agent, in receiving payment, acts only in the providers' behalf.

CMS may pay the providers' benefits in accordance with an assignment established by, or pursuant to the order of, a court of competent jurisdiction.

A provider should notify us immediately if:

• CMS has been mailing its benefits to the address of another person or organization;
• The provider has given that other person or organization power of attorney or other advance authority to negotiate its benefit checks; and
• None of the above exceptions that would permit payment to another person or organization apply in the provider's case.

A provider which hereafter enters into or continues such a prohibited payment arrangement may have its participation in the program terminated and its right to receive assigned payment for physician services revoked.

MEDICARE PART A:

The Authorization Agreement for Electronic Funds Transfer, form CMS-588, can be found on the CMS website at www.cms.hhs.gov/cmsforms/downloads/cms588.pdf . By signing the CMS-588, you are certifying that the account is in compliance with the CMS instructions. The agreement must be signed by the authorized or delegated official who signed the Provider Enrollment Application, CMS 855. If no CMS-855 is on file in our office, the provider must submit one. Refer to Medicare News Update 2003-9 for additional information.

Please send the completed CMS-588 form to:

Please contact Provider Inquiries at (888) 855-4356 with any questions relating to where to send the completed CMS-588 EFT Form.

NOTE: Please be sure to include a voided check or preprinted deposit slip showing the ABA number, account number, and provider name. If a check or deposit slip is not available, you will need to obtain a letter from the bank stating the name listed on the account and the complete account numbers. The provider's name must be on the account in order to comply with CMS requirements for EFT.

MEDICARE PART B:

To request EFT for Medicare Part B, please call the EMC Marketing Department at (212) 476-7952.

Page Last Modified: 10/05/07