Thanks to the efforts of TMA member U.S Rep. Michael Burgess, MD (R-Texas), the Centers for Medicare & Medicaid Services (CMS) plans to withdraw its rule requiring physicians to sign laboratory requisition forms, the American Medical Association says. The requirement was included in the 2011 Medicare fee schedule and was supposed to go into effect April 1.
"Congressman Burgess put in a lot of hard work to get the support needed to get the rule revoked," according to AMA.
Long-term care facilities were especially upset with the requirement because physicians often order lab tests for their patients in the facilities over the telephone. They argued the requirement would slow the process.
"One of the reasons we made this proposal is because we believed that it would be less confusing for a physician's signature to be required for all requisitions and orders, eliminating uncertainty over whether the documentation is a requisition or an order, whether the type of test being ordered requires a signature, or which payment system does or does not require a physician signature," CMS said when it proposed the requirement.
In early February, Representative Burgess and several other members of Congress wrote CMS Administrator Donald Berwick, MD, [PDF] that the requirement could harm Medicare patients because care might be delayed. "Under this new policy, laboratories will face a difficult decision when they receive a patient specimen with an unsigned requisition," the letter said. "Laboratories will have to decide not to provide their needed services and therefore be unable to provide a physician the information necessary to make health care decisions, or to provide the services without guarantee of payment, then work to obtain signatures in order to submit claims to Medicare."
The letter asked for additional time for CMS "to work with the laboratory, physician, hospital, and long-term care communities to put in place safeguards to ensure patient care is not negatively affected, allay concerns on possible payment complication stemming from this new requirement, and ensure a streamlined process for health care providers."
Action, March 1, 2011