Medicare Lab Signature Rule Delayed Again

April 6, 2011

The Centers for Medicare & Medicaid Services again delayed enforcement of a new Medicare rule requiring physicians to sign-off on laboratory test requests. The rule is expected to be rescinded, after complaints from physicians groups and lawmakers.

The Centers for Medicare & Medicaid Services (CMS) again delayed enforcement of a new Medicare rule requiring physicians to sign-off on laboratory test requests, as the agency continues to come under pressure from physicians groups and lawmakers.

CMS is in the process of rescinding the signature requirement, which has been slated to go into effect Jan. 1. Until the rule is repealed the agency will not enforce the requirement, JoAnne Glisson, senior vice president of the American Clinical Laboratory Assn. in Washington, D.C., told American Medical News.

The rule would have created another costly and time-consuming paperwork backlog for clinicians who need to order and fill lab test requests, groups such as the American Medical Association and others have charged.

Lawmakers had also requested a delay in enforcement, citing concerns about patient care. In a letter to the CMS signed by 87 lawmakers, Texas Reps. Michael Burgess, MD (R., Texas) and Bill Pascrell, Jr. (D., N.J.) said, "We worry about how the rule could affect Medicare beneficiaries where such lab services are necessary for a physician to make critical decisions that affect patients' health and well-being, often under significant time constraints, and urge CMS to consider these situations as they examine this policy." A similar letter was sent by a group of 34 senators a day later.

Physicians groups, including the AMA, had called for the agency to eliminate the requirement permanently. "We clearly communicated to CMS that the added administrative hassles this rule would impose on physicians were burdensome and unnecessary," AMA President Cecil B. Wilson, MD, told American Medical News. "CMS' decision to reverse this policy will allow physicians to spend less time on paperwork and more time on patient care. This decision is an important step as the administration works to ease regulatory burdens for businesses, including physician practices."

The signature requirement will most likely be rescinded when the proposed Medicare physician fee schedule is released this summer, Glisson told American Medical News.