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February 14, 2018

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There’s No Going Back After Transition to EFT

October 14, 2008:

Once a provider starts receiving electronic funds transfer payments under Medicare, receiving a paper check is rarely an option, according to the Centers for Medicare and Medicaid Services. CMS requires electronic funds transfer payments for all new providers as well as existing providers who have submitted a change to their existing provider file but are not currently enrolled in EFT.

CMS issued this announcement (CR-5974) in order to ensure consistency in the instructions between Pub.100-08, chapter 10, section 8 and Pub.100-04, chapter 24, section 40.7, regarding electronic funds transfer.

Once a provider has started to receive Medicare payments electronically, contractors are not permitted to issue any “routine, ongoing” payments to the provider via check. CMS defines “routine, ongoing” as “not considered to be special payments”—this is a term used in section 4 of the CMS-855 enrollment application. Simply put, this means that with the exception of “special payments,” once a provider receives Medicare payments electronically, he or she cannot return to receiving paper checks. This includes situations involving a transition to a Medicare administrative contractor or any other CMS-initiated action. Medicare contractors will not approve any requests to change a provider’s payment status from electronic to check.

An exception to this policy is granted when CMS implements a new MAC and moves workload from existing intermediaries and carriers to the MAC. The new MAC must obtain and retain a signed EFT authorization agreement (CMS-588) from every provider and supplier who has requested EFT. Each provider who fails to return a completed CMS-588, particularly high-volume submitters, should be personally contacted by the MAC. However, the MAC will not hold up any provider or supplier’s EFT for lack of this document until it obtains CMS authorization. If all attempts to reach the provider fail, CMS will direct the MAC to issue and mail a paper check. No provider or supplier is permitted to pick up checks or request next-day delivery, express mail, or courier services unless there are special circumstances approved by CMS.

Medicare contractors are required to comply with instructions in Pub.100-08, chapter 10, sections 4.4 and 8, for all provider enrollment issues related to electronic funds transfer. This includes the requirement that all carriers, MACs, fiscal intermediaries, and regional home health intermediaries compare information and signatures on the provider form CMS-588 against the CMS-855 form on file.


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