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April 2011
Clinical Practice Management
CMS Reconsiders Physician Signature Requirement for Lab Services
Certifying home health services under Medicare still requires face-to-face visit

Federal officials are reconsidering a potentially burdensome paperwork rule that would have required physicians to provide their signatures on requisitions for laboratory tests. The Centers for Medicare and Medicaid Services (CMS) is now taking another look at the policy and considering next steps, according to recent reports in Inside Health Policy and American Medical News

The signature requirement was included in Medicare’s 2011 physician fee schedule but has never been enforced by CMS. Several lawmakers had asked the agency to change or delay the rule, while the American Medical Association called for CMS to abolish it permanently, citing the additional and unnecessary administrative burden it would impose.

Another 2011 fee schedule change, which may affect ID physicians with patients receiving home health services, such as home antibiotic infusion therapy, remains in place. Certifying that a patient is eligible for these services under Medicare now requires a face-to-face visit by the physician or a non-physician practitioner working in collaboration with the physician. This visit and how the patient’s condition supports the need for home health services must be documented. The visit must occur within the 90 days prior to the start of home health care or within 30 days after the start of care.

For more information, see this one-page summary (PDF) of the visit requirement prepared by CMS. IDSA’s website also offers a physician guide for certifying and recertifying patients for home care, including details about coding and allowable reimbursement. (You must be logged in to access this page.)


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