In a previous Payment Matters article, we reported that CMS had instructed its Medicare contractors not to enforce the requirement that it had included in the Medicare Physician Fee Schedule Rule (MPFS) for calendar year 2011, requiring a physician or qualified non-physician practitioner (NPP) to sign the requisition for a clinical diagnostic laboratory test. "CMS Sign-Off On Enforcement of Physician Signature Requirement on Lab Requisitions" (April 28, 2011). We indicated that rescission of the requirement might, however, require the agency to comply with Administrative Procedure Act (APA) notice and comment requirements. That has turned out to be the case.

On June 30, 2011, CMS issued a proposed rule that would retract the signature requirement [PDF]. CMS explained its policy change by stating that there were many situations, including frequent delay of care, that it could not have recognized as being problematic until it finalized the policy and received comments from "industry stakeholders" who had begun to implement it.

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