June 30, 2011

CMS Officially Withdraws Physician Signature Requirement

As we previously reported here and here, it was just a matter of time before the Center for Medicare & Medicaid Services (CMS) officially withdrew its rule requiring physician signatures on all laboratory requisitions for clinical diagnostic laboratory tests paid under the Clinical Laboratory Fee Schedule (CLFS). Today, CMS formally withdrew this requirement based on objections from various stakeholders, which primarily came from the lab industry. The official retraction, as published in the Federal Register, is available here.

As acknowledged by CMS in the background section of this official rule, stakeholders objected because there are numerous instances when it would be difficult, if not impossible, for laboratories to obtain the signatures of physicians or non-physician practitioners (NPPs) on requisitions. CMS specifically mentioned the difficulties that the physician signature requirement would create in the context of nursing homes and other long term care settings. With refreshing candor, CMS stated that “[e]ven in cases where the physician or NPP sees the patient in his/her offices for an appointment and recommends that clinical diagnostic laboratory testing be performed, we now better understand that, typically, the information is transcribed from the medical record onto a paper requisition by office staff after the physician or NPP and the patient have concluded their interaction. In practice, we can see how requiring the physician or NPP to sign the paper requisition could, in some cases, be very inconvenient and disruptive to the physician, NPP, the beneficiary, and other patients.”

With the physician signature requirement having been officially retracted, the laboratory industry and all of those other providers, patients and stakeholders who would have been adversely affected can now rejoice.

This post was contributed by Kurt Bratten.