CMS Clarifies POC Physician Signature Requirements

Happy 2011 to all MFS Bloggers,

CMS recently clarified its position with regard to physician's signing and dating Plans of Care. I have seen many POC denial determinations and post-payment audits incorrectly assessed by various Intermediaries based upon this policy.

Palmetto GBA published clarification due to recently received clarifications from the Centers for Medicare & Medicaid Services (CMS) in reference to physician signatures with stamped dates. CMS has clarified that physicians must sign and date home health plans of care, verbal orders and certifications. This changes Palmetto GBA's long standing policy of accepting a date stamp or facsimile date as proof of timeliness in lieu of a physician dating his/her signature. This change is effective for all documents signed on or after January 1, 2011.

Based on the following CMS references, failure to meet these requirements may result in full or partial denial of services.

- CMS Internet Only Manuals (IOMs), Publication 100-01, Medicare General Information, Eligibility and Entitlement Manual, Chapter 4, Section 30.1 states that "the attending physician signs and dates the POC/certification prior to the claim being submitted for payment."

- This manual requirement is also addressed in 42 CFR 424.22 (D)2 effective January 1, 2011, and states that "the certification of need for home health services must be obtained at the time the plan of care is established or as soon thereafter as possible and must be signed and dated by the physician who establishes the plan.' The instructions for re-certifications are found in this same Part and restates that it 'must be signed and dated by the physician who reviews the plan of care."