CMS is expected to withdraw its new policy requiring physicians to sign requisitions for clinical laboratory tests. In November 2010, CMS finalized its policy, to be effective January 1, 2011, requiring all requisitions for clinical diagnostic laboratory tests paid on the basis of the clinical laboratory fee schedule to be signed by a physician or qualified nonphysician practitioner. 75 Fed. Reg. 73170, 73480-83 (Nov. 29, 2010). CMS defines a requisition as “the actual paperwork, such as a form, which is provided to a clinical diagnostic laboratory that identifies the test or tests to be performed for a patient.” 75 Fed. Reg. at 73483. However, in response to concerns from laboratories regarding the burdens of this new requirement, CMS delayed enforcement and said it would “spend the first quarter of 2011 developing educational and outreach materials that will be posted on the CMS website.” The rule was expected to be enforced beginning April 1, 2011.
Recently, bipartisan letters from both the United State House of Representatives and Senate were sent to CMS requesting that CMS delay enforcement of the rule for an additional nine months, as “more time is needed for CMS to work with physicians and the lab community on this rule and to discuss the potentially serious implications on patient care and business practice.” Both the House and the Senate cautioned that situations would arise in which urgent laboratory services were needed but a physician was unavailable for signature. The letter from the House is available by clicking here, and the letter from the Senate is available by clicking here.
Two clinical laboratory associations, which have been discussing the burdens of the rule with CMS, are reporting that CMS will rescind the rule.