States mandating era or eft

Posted by / 14-Sep-2017 17:10

NACHA develops rules, published in NACHA Operating Rules & Guidelines--A Complete Guide to the Rules Governing the ACH Network (hereinafter referred to as the NACHA Operating Rules & Guidelines, available at https:// that govern the ACH Network.The NACHA Operating Rules & Guidelines is an annual publication divided into two sections, the NACHA Operating Rules and the NACHA Operating Guidelines.[Federal Register Volume 77, Number 6 (Tuesday, January 10, 2012)] [Rules and Regulations] [Pages 1555-1590] From the Federal Register Online via the Government Publishing Office [gov] [FR Doc No: 2012-132] Page 1556 ----------------------------------------------------------------------- DEPARTMENT OF HEALTH AND HUMAN SERVICES Office of the Secretary 45 CFR Parts 160 and 162 [CMS-0024-IFC] RIN 0938-AQ11 Administrative Simplification: Adoption of Standards for Health Care Electronic Funds Transfers (EFTs) and Remittance Advice AGENCY: Office of the Secretary, HHS. ----------------------------------------------------------------------- SUMMARY: This interim final rule with comment period implements parts of section 1104 of the Affordable Care Act which requires the adoption of a standard for electronic funds transfers (EFT).It defines EFT and explains how the adopted standards support and facilitate health care EFT transmissions. ------------------------------------------------------------------------ In the July 8, 2011 Federal Register (76 FR 40458), we published an interim final rule with comment period, ``Administrative Simplification: Adoption of Operating Rules for Eligibility for a Health Plan and Health Care Claim Status Transactions'' (hereinafter referred to as the Eligibility and Claim Status Operating Rules IFC).We post all comments received before the close of the comment period on the following Web site as soon as possible after they have been received: Electronic Funds Transfers (EFT): General Background While industry and consumers use the term EFT in a number of different ways, the definition of EFT in section 31001(x) of the Debt Collection Improvement Act of 1996 (Pub. 104-134) is particularly useful in this general background discussion because it includes a broad spectrum of transmission vehicles and terms that are relevant to our discussion of EFT in this interim final rule with comment period.Follow the search instructions on that Web site to view public comments. Statutory and Regulatory Background The background discussion below presents a partial statutory and regulatory history related only to the statutory provisions and regulations that are important and relevant for purposes of this interim final rule with comment period. HIPAA amended the Social Security Act (hereinafter referred to as the Act) by adding Part C--Administrative Simplification--to Title XI of the Act, requiring the Secretary of the Department of Health and Human Services (DHHS) (hereinafter referred to as the Secretary) to adopt standards for certain transactions to enable health information to be exchanged more efficiently and to achieve greater uniformity in the transmission of health information. The Debt Collection Improvement Act defines an EFT as ``any transfer of funds, other than a transaction originated by cash, check, or similar paper instrument that is initiated through an electronic terminal, telephone, computer, or magnetic tape, for the purpose of ordering, instructing, or authorizing a financial institution to debit or credit an account.This electronic transmission from a business to its financial institution is sometimes referred to as ``payment initiation,'' ``payment instructions,'' ``payment authorization,'' or ``originating an entry.'' To order, instruct or authorize a financial institution to make an EFT payment through the ACH Network, the business or entity that is making the payment, designated as an ``Originator'' in the NACHA Operating Rules & Guidelines, must provide its financial institution, called the ``Originating Depository Financial Institution'' or ODFI, with payment information similar to information that one would find on a paper check.This payment information includes the amount being paid, identification of the payer and payee, bank accounts of the payer and payee, routing information, and the date of the payment.


NACHA develops rules, published in NACHA Operating Rules & Guidelines--A Complete Guide to the Rules Governing the ACH Network (hereinafter referred to as the NACHA Operating Rules & Guidelines, available at https:// that govern the ACH Network.


Subsequent regulations implementing this act allowed for waivers and exceptions.

For information on viewing public comments, see the beginning of the SUPPLEMENTARY INFORMATION section. Eligibility for a health plan (request and response)-- Dental, professional, and institutional. Eligibility for a health plan (request and response)--Retail pharmacy drugs. Sections 1104(b)(2)(B) and 10109(a)(1)(B) of the Affordable Care Page 1558 Act also amended section 1173 of the Act by adding sections 1173(a)(4) and (5), respectively, to provide for new financial and administrative transactions requirements.FOR FURTHER INFORMATION CONTACT: Matthew Albright (410) 786-2546. SUPPLEMENTARY INFORMATION: Inspection of Public Comments: All comments received before the close of the comment period are available for viewing by the public, including any personally identifiable or confidential business information that is included in a comment. Section 1173(a)(4) guides us in adopting standards in this interim final rule with comment period and associated operating rules (which we will adopt in future rulemaking) for the EFT transaction, particularly the following requirements: First, such standards and associated operating rules must ``be comprehensive, requiring minimal augmentation by paper or other communications;'' second, the standards and associated operating rules must ``describe all data elements (including reason and remark codes) in unambiguous terms [and] require that such data elements be required or conditioned upon set values in other fields, and prohibit additional conditions (except where necessary to implement State or Federal law, or to protect against fraud and abuse);'' and third, the Secretary must ``seek to reduce the number and complexity of forms (including paper and electronic) and data entry required by patients and providers.'' B.The National Automated Clearing House Association (NACHA) was founded in 1974 to centrally coordinate the local ACH associations and to administer, develop, and enforce operating rules and management practices for the ACH Network.In 1978, in a joint effort between NACHA and the Federal Reserve System, regional ACHs were linked electronically, with NACHA serving as the national ACH Network's administrator.

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In 31 CFR 210, the United States Department of the Treasury formally adopted the NACHA Operating Rules & Guidelines for the Federal government's EFT payments made through the ACH Network, including Federal tax collections, tax refund payments, and Social Security and other benefit payments made by direct deposit. The Payment Flow Through the ACH Network To give context to how EFT are used in the health care industry, we consider here how businesses pay one another by transferring funds and sending related payment information through the ACH Network.

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