Congress Successfully Pushes CMS to Review and Rescind Burdensome Requirement

Washington, D.C. – In February eighty-eight Members of the House and the Senate, led by Congressman Michael C. Burgess, M.D. (R-TX-26), Congressman Bill Pascrell Jr. (D-NJ-08), Senator Robert Menendez (D-New Jersey) and Senator Pat Roberts (R-Kansas), sent bipartisan letters to Dr. Donald Berwick, Administrator for the Centers for Medicare and Medicaid Services (CMS) urging him to delay and review enforcement of a new requirement that was included in the 2011 Medicare Physician Fee Schedule Final Rule. Today, the provision that would require laboratory requisition forms to be signed by the ordering physician was proposed to be rescinded.

“The new enforcement was unnecessary and went beyond delaying care, Medicare beneficiaries could end up spending a lot of their time contacting providers to get required signatures and providers could see their payments delayed or worse, possibly denied for a new administration hurdle,” said Dr. Burgess who serves as the Vice-Chair of the Energy and Commerce Subcommittee on Health. “Creating more bureaucracy, in a system that can sometimes already be hard to navigate, only creates more problems. Patients, physicians, hospitals, nursing homes, and laboratories could not afford to have this change implemented, and all supported this effort. I am glad to see that CMS made the right decision in pulling this provision back so that we can put patient care first.”

“I have heard from numerous laboratories and physicians throughout Kansas about the difficulties this rule would have caused their practices, including additional costs and delays for patients and providers alike and I am pleased that sound reason has prevailed in the decision to retract this burdensome rule,” said Roberts.

 “In medicine, our goal must be to cure the sick, not create headaches with medical red tape,” said U.S. Sen. Robert Menendez (D-NJ). “I’m glad the Centers for Medicare and Medicaid Services took the time to evaluate the impact of its policy regarding physician signature requirements and has determined that it’s best to change course on its policy. Doing so removes unnecessary roadblocks for patients, doctors and businesses.”

“This good news to anyone who believes that our health care system is already complicated enough. Patients, health care providers and laboratories need government’s help, not harassment. It appears today that the CMS is recognizing that fact,” said U.S. Rep. Bill Pascrell, Jr. (D-NJ-8), a member of the House Ways and Means and Budget Committees. “As Congress members work to make sure that eligible Americans continue to receive the Medicare and Medicaid benefits they deserve, I’m a glad that the CMS is willing to consider removing an unnecessary requirement from their processes.”

CMS created the new requirement without a legislative mandate and explicitly required a physician signature on requisitions for clinical diagnostic laboratory tests paid under the clinical laboratory fee schedule. In addition, CMS was misguided further by trying to implement this rule without concern for the timeframe necessary to ensure access or educate providers of what would have been a significant change of procedure. Health care laboratories are pleased with the decision to withdraw the requirement.

“On behalf of community and regional laboratories, many of which care for our most vulnerable Medicare beneficiaries, the National Independent Laboratory Association is relieved CMS understood the negative ramifications their rule would have had on patients and community labs across the country. We are grateful for the leadership of Congressmen Burgess and Pascrell in helping us communicate our concerns to CMS.” - Mark Birenbaum, PhD, National Independent Laboratory Association 

“ACLA sincerely appreciates CMS rectifying this unworkable situation ensuring there will be no disruption in the provision of vital clinical laboratory services to Medicare beneficiaries,” stated ACLA President Alan Mertz.  “Clarifying the situation once and for all is important so that all Medicare providers and contractors have unambiguous direction on this policy change,” added Mertz.

• To view the letter Members of Congress sent to CMS click here.
• To view the letter Members of the Senate sent to CMS click here.