CMS Issues Clarification on Physician Signature Requirements

To:      NHPCO Members
From:  NHPCO Regulatory & Compliance Team
Date:   April 1, 2008

On March 28, 2008, CMS posted a clarification of the instructions on signature requirements for physicians, CR5971.

Stamped Signatures:
Medicare requires a legible identifier for services provided/ordered. The method shall be hand written or an electronic signature. Stamp signatures are not acceptable.

Facsimile Signatures:
Facsimile of original written or electronic signatures are acceptable for the certification of terminal illness for hospice. The guidance also states that hard copies of the facsimile signatures and physician's electronic signature must be in the patient's medical record for the certification of terminal illness for hospice.

Electronic Signatures:
Electronic signatures by physiciansare allowed. Providers need a system and software products that are protected against modification and should apply administrative procedures which are adequate and correspond to recognized standards and laws. Note that the CR requires that the hospice must have a hard copy of the physician's signature and must place the hard copy in the patient's medical record for certification of terminal illness. The individual whose name is featured on the electronic signature method and the provider bear the responsibility for the authenticity of the information being attested to.

View CMS Transmittal 248 (CR 5671) on the CMS Web site (PDF).

Questions may be directed to NHPCO's Regulatory and Compliance Team at regulatory@nhpco.org.