CMS Rescinds Physician Signature Requisition Requirement
I have always been a little uncomfortable with the
saying "the squeaky wheel gets the oil."
I understand the sentiment, but I did not philosophically agree that one
had to be loud or confrontational to be heard.
I have to say that in the case of the CMS
requirement for physician signature on lab requisitions, the laboratory
community was the squeaky wheel that got the oil!
In the 2011 Medicare Physician Fee Schedule Final
Rule, published in the Nov. 29, 2010 edition of the Federal Register, the Centers for
Medicare and Medicaid Services (CMS) stated its intention to begin
requiring physician signatures on all laboratory requisition forms reimbursable by Medicare
beginning on Jan. 1 of this year.
In typical CMS fashion, a combination of
housekeeping issues and protests from stakeholders caused CMS to move the implementation
date to April 2011. But in any event it
seemed that it was going to be a done deal.
Asked for clarification, CMS made it clear that "laboratory
requisition forms are those documents provided to a clinical diagnostic
laboratory that identify the test or tests to be performed, but they are not
considered to be physician orders that heretofore required a physician's signature."
While laboratorians saw the need for physician orders to be signed they realized the
difficulty of ensuring that requisitions were signed as well.
Most concentrated not just on the difficulty of
ensuring such a requirement and the impact it would have on laboratories, but pointed out the various ways in which patient care
In a rare show of unity laboratory professional
groups (ASCLS, ASCP, AACC and AMT), American
Clinical Laboratory Association (ACLA) representing industry, and other
stakeholders flooded CMS with calls, emails and faxes. They created in effect a
In a clear response to this outcry, it was announced
that CMS is rescinding that requirement
Laboratorians can breathe a sigh of relief. More
importantly they can pat themselves on the back for the fact that in this one
case (unlike so many others) they actually did something other than whine and
wring their hands.
They not just squeaked, they found their voice and
roared. Let's hope that having found their voice, laboratorians won't lose it