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Pennsylvania House of Representatives
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House of Representatives
Session of 2023 - 2024 Regular Session


Posted: August 31, 2023 08:55 PM
From: Representative Arvind Venkat
To: All House members
Subject: Prohibiting Disproportionate Electronic Payment Fees Charged to Physicians and Medical Practices
In 2021, with more than $2 trillion in medical claims being paid electronically to physicians and medical practices, an estimated 60% of medical practices were required to pay significantly disproportionate fees for electronic payments. Electronic payment fees can cost large medical practices an estimated $1 million annually and roughly $100,000 for smaller medical practices (The Hidden Fee Costing Doctors Millions Every Year — ProPublica). These are fees that come out of agreed upon payments for services and therefore decrease the tenuous margins under which medical practices are operating.
The Secretary of the United States Department of Health and Human Services is required to adopt standards regarding electronic health care transactions under the Health Insurance Portability and Accountability Act. However, once these standards were adopted, physicians began noting the excessive fees that they were being charged by insurers and third-party vendors for electronic payments that were meant to facilitate more efficient and timely reimbursement for clinical services. The Centers for Medicare and Medicaid Services responded to the complaints by stating that they had no legal authority to flat-out prohibit electronic payment fees.
For these reasons, I will be introducing a resolution that would urge the United States Congress to pass legislation that would require the Secretary of the United States Department of Health and Human Services to update or issue new regulations to prohibit disproportionate electronic payment fees for physicians and medical practices for agreed-upon reimbursement for clinical services.
Please join me in co-sponsoring this resolution to alleviate this unnecessary cost physicians are being subjected to for providing patient care.

Introduced as HR199