CMS Formally Scraps Controversial Physician Signature Requirement

CMS has formally rescinded its policy requiring the signature of a physician or a nonphysician practitioner (NPP) on paper requisitions for clinical laboratory services payable under the Medicare lab fee schedule. The policy retraction was published in the final 2012 Medicare physician fee schedule rule, released Nov. 1 and scheduled to appear in the Nov. 28 Federal Register. At the same time, the agency has reinstated its prior policy that the signature of the physician or NPP is not required on a paper requisition for a clinical diagnostic laboratory test paid under the Medicare lab fee schedule. Despite its change of mind, CMS noted in the 2012 final physician fee rule that it remains concerned about the potential for fraud and abuse, emphasizing that “the requirement that the treating physician or NPP must document the ordering of the test remains, as does our longstanding policy that requires orders, including those for clinical diagnostic laboratory tests, to be signed by the ordering physician or NPP.”