New Jersey law protects payment choice, while federal rules protect access to standardized electronic payment and remittance transactions 

The American Dental Association (ADA) reports that Aetna plans to discontinue paper checks for out-of-network dentists. The ADA has urged Aetna to reconsider the change because it may conflict with payment-choice laws in several states (ADA, 2026).  

The ADA advises dentists with concerns to contact Aetna, review applicable state laws and consider contacting their state insurance regulator. The ADA is also working with state dental associations as the issue develops (ADA, 2026).  

The New Jersey Dental Association (NJDA) has received multiple member inquiries concerning Aetna notices scheduled to take effect September 4, 2026. NJDA is also seeking clarification from Aetna about the payment and remittance options that will remain available to New Jersey out-of-network dentists. 

What Aetna’s notice says 

An Aetna provider notice dated July 6, 2026, and reviewed by NJDA states that paper checks and paper explanations of benefits will be discontinued beginning September 4, 2026. The notice advises that providers who do not enroll in electronic funds transfer, or EFT, may receive payments through virtual credit cards, or VCCs (Aetna provider notice, July 6, 2026). 

The notice also states that “contracted dental providers may select the payment delivery method of their choice, including check payments” (Aetna provider notice, July 6, 2026). 

The language reviewed by NJDA does not clearly explain whether out-of-network dentists may continue to receive paper checks. The ADA separately reports that Aetna has announced it will discontinue checks for out-of-network dentists (ADA, 2026).  

NJDA has asked Aetna to confirm the payment options available to New Jersey OON dentists and to explain how providers may select or change their payment method. 

What does New Jersey law require? 

New Jersey’s provider-payment-choice law is P.L. 2023, c.247, codified at N.J.S.A. 17B:30-34.1. 

For OON providers, New Jersey law provides that a carrier or its contracted vendor may not restrict an OON provider furnishing covered OON services “to only one form of payment” (N.J.S.A. 17B:30-34.1(b)).  

The statute identifies credit card, EFT and check as examples of payment methods. It also defines “health care provider” to include a dentist and defines “credit card” to include a single-use or virtual credit card (N.J.S.A. 17B:30-34.1(h)).  

When an available payment method has an associated fee, the carrier or its vendor must notify the provider that fees may apply and disclose fees beyond those the provider would normally incur when processing that particular type of payment (N.J.S.A. 17B:30-34.1(c)(1)).  

The carrier must also provide clear instructions explaining how the provider may select each available payment method (N.J.S.A. 17B:30-34.1(c)(2)).  

When a provider requests a change among the available payment methods, the carrier generally must implement the selected change within 30 business days, subject to state and federal fraud-prevention verification requirements (N.J.S.A. 17B:30-34.1(d)).  

The statute prohibits carriers from considering a provider’s preferred payment method when making credentialing decisions. It also provides that its protections cannot be waived by contract (N.J.S.A. 17B:30-34.1(e)–(f)).  

Does New Jersey law guarantee paper checks? 

The final law does not expressly require carriers to continue offering paper checks. 

Although the statute lists check as an example of a payment method, it prohibits restricting an OON provider to only one payment method. It does not state that check, EFT and credit card must each be offered (N.J.S.A. 17B:30-34.1(b)).  

Earlier versions of the legislation would have required carriers to offer all reasonably available payment methods, including check and EFT. That language was replaced before enactment with the current prohibition against offering only one payment method (A4913, Second Reprint).  

Based on the final language, NJDA’s current interpretation is that offering both VCC and EFT could satisfy the statute’s basic requirement that an OON dentist not be restricted to only one payment method. The statute does not expressly state that this particular combination is sufficient, so NJDA is asking Aetna to confirm its interpretation and implementation. 

Aetna must still ensure that both options are genuinely available, properly disclose applicable fees, provide clear selection instructions and timely implement a provider’s request to change among the available options. 

Must one of the payment methods be fee-free? 

New Jersey law does not expressly require that at least one payment method be free. 

Instead, the statute anticipates that an available payment method may have an associated fee and establishes disclosure requirements when fees apply (N.J.S.A. 17B:30-34.1(c)).  

Aetna’s public provider information states, “We won’t charge you a fee for EFT, but your bank might.” Aetna also states that medical and dental providers may enroll in EFT through Optum’s Payer Enrollment Services (Aetna, accessed July 23, 2026).  

NJDA is asking Aetna to confirm that this statement applies to OON New Jersey dentists and that neither Aetna nor its enrollment vendor imposes an enrollment, subscription, transaction, reassociation or other vendor charge for basic ACH EFT. 

Why virtual credit cards may be costly 

The ADA explains that VCC payments are processed through credit card networks rather than through the HIPAA-adopted ACH EFT standard. Because VCC transactions are generally subject to card-processing fees, the ADA states that dentists are more likely to incur fees when accepting VCC payments than when receiving standardized ACH EFT payments (ADA, 2026).  

The ADA has also received complaints that some third-party payment vendors charge for additional services bundled into the enrollment process, including automatic reassociation, expedited payment and practice-management integration (ADA, 2026).  

Based on the ADA’s guidance, NJDA recommends that dentists review EFT enrollment agreements carefully and ask specifically for a basic ACH EFT option without unwanted or optional paid services (ADA, 2026).  

Dentists should also ask their financial institutions whether the bank charges a fee for incoming ACH payments. The ADA explains that a fee imposed independently by the dentist’s bank is separate from a fee imposed by the carrier or its payment vendor (ADA, 2026).  

Why is NJDA citing CMS for a commercial dental plan? 

The Centers for Medicare & Medicaid Services (CMS) is relevant here not because these are Medicare claims, but because CMS’s National Standards Group administers and enforces the federal HIPAA Administrative Simplification standards governing electronic claims, payments and remittance transactions. 

CMS explains that the standards apply to HIPAA-covered health plans, clearinghouses and providers conducting electronic administrative transactions. For HIPAA purposes, health plans include private health insurance companies, HMOs, employer-sponsored health plans and government health programs (CMS, 2026).  

CMS also states that the adopted standards apply to covered entities “not just those who accept Medicare or Medicaid” (CMS, 2026).  

Accordingly, the federal EFT and ERA requirements can apply to commercial carriers such as Aetna when the carrier or plan is acting as a HIPAA-covered health plan. Specific exceptions may apply to certain arrangements, but network participation is not a condition of the federal EFT and ERA protections. 

Federal law gives providers the right to request standardized ACH EFT 

Federal regulations provide that when an entity asks a health plan to conduct a covered transaction as a standard transaction, the health plan must do so (45 C.F.R. § 162.925(a)(1)).  

The federal regulations adopt the NACHA CCD+ Addenda format and related X12 specifications for standardized ACH EFT payments, along with the X12 835 standard for remittance advice (45 C.F.R. § 162.1602).  

CMS states that when a provider requests that a health plan make payment through the ACH Network using the adopted EFT standards, the plan must comply. The provider must complete the plan’s applicable enrollment process (CMS, 2022).  

CMS also expressly states that a provider does not have to participate in the health plan’s network to receive standardized EFT and ERA transactions (CMS, 2022).  

Federal HIPAA rules do not require a health plan to honor a provider’s request for a paper check. CMS explains that the federally required payment method, when properly requested, is ACH EFT—not paper check (CMS, 2022).  

Can a health plan or payment vendor charge for EFT? 

CMS states that charging a fee for an EFT or ERA transaction is not, by itself, automatically prohibited under HIPAA. CMS also explains, however, that conditioning access to standardized EFT or ERA transactions on a provider’s acceptance or purchase of unwanted payment or reassociation services may be considered an attempt to adversely affect the provider or transaction (CMS, 2022).  

This means the federal rules do not establish a simple rule that every ACH EFT must be free. Nevertheless, a carrier should not make receipt of the standard transaction dependent on purchasing unwanted value-added services. 

New Jersey law separately requires disclosure of fees associated with the available payment methods (N.J.S.A. 17B:30-34.1(c)).  

What about the elimination of printed EOBs? 

NJDA has not identified a New Jersey statute or regulation that expressly requires a carrier to mail a printed provider EOB or remittance statement for every claim. 

New Jersey’s prompt-payment regulation requires a carrier that denies or disputes a claim to notify the provider of the basis for its decision. The notice must identify and explain the reasons for the denial or dispute, identify required missing information, explain disputed amounts or coding changes and provide a telephone number for questions (N.J.A.C. 11:22-1.6).  

The regulation does not expressly establish a general right to have all provider payment and remittance information delivered through a mailed paper EOB. This is NJDA’s interpretation of the current regulation, not an express statement by the Department of Banking and Insurance. 

The elimination of printed EOBs does not necessarily mean that a practice must manually retrieve every claim explanation from Aetna’s portal. 

What is an electronic remittance advice? 

CMS defines an electronic remittance advice, or ERA, as an explanation from a health plan to a provider concerning a claim payment. An ERA describes payment processing and adjustments involving issues such as benefit coverage, secondary payers, copayments and coinsurance (CMS, 2026).  

The federally adopted ERA standard is X12 Version 5010 835. CMS explains that matching trace information in the ACH payment and the associated ERA helps practices reassociate the payment with the correct remittance information (CMS, 2026).  

When a provider requests remittance information in the standard X12 835 format, CMS states that the health plan must comply with that request (CMS, 2022).  

CMS also states that posting remittance information to a web portal does not replace the plan’s obligation to transmit the standard 835 transaction when the provider requests it. The provider may request delivery directly or through a clearinghouse acting on the provider’s behalf (CMS, 2022).  

Aetna’s public provider page states that medical and dental providers can enroll in ERA through Optum’s Payer Enrollment Services. Aetna separately makes electronic EOBs available through the Availity portal (Aetna, accessed July 23, 2026).