On March 31, 2011, CMS informed its Provider Resource mailing list that it intends to change the regulation requiring physician or qualified non-physician practitioner signatures on requisitions for clinical diagnostic laboratory tests paid under the clinical laboratory fee schedule. According to CMS, this change, due by the end of the year, stemmed from concerns that physicians, qualified non-physician practitioners, and clinical diagnostic laboratories were having difficulty complying with the regulation. The text of the email may be found here.
CMS outlined its interpretation of 42 C.F.R. § 410.32 to require signatures on acquisitions for clinical diagnostic laboratory tests in the November 29, 2010, Medicare Physician Fee Schedule final rule. 75 Fed. Reg. 73170, 73483 (Nov. 29, 2010). The final rule required that the paperwork provided by physicians to clinical diagnostic laboratories that identified the test(s) to be performed contain the physician’s (or qualified non-physician practitioner’s) actual signature. On December 20, 2010, CMS informed contractors that many of the parties covered by this regulation were either unaware of the rule or did not properly understand the rule. Therefore, CMS told its contractors, the agency would spend the first quarter of 2011 conducting an educational campaign before enforcing the regulation. During the first quarter, however, CMS decided to focus on changing the rule rather than on educating affected entities.