News in brief - April 4, 2011

Medicare lab signature mandate to be delayed further

The Centers for Medicare & Medicaid Services will further delay enforcement of a rule requiring physician signatures on laboratory requisitions, according to members of organized medicine.

The agency had sent an interim final rule that rescinds the signature requirement to the White House Office of Management and Budget for review on March 21. However, administration lawyers said the interim rule could not go forward and that CMS must go through the proper federal rulemaking process.

In the meantime, CMS will continue not to enforce the physician signature rule, said JoAnne Glisson, senior vice president of the American Clinical Laboratory Assn. in Washington, D.C.

The requirement technically took effect Jan. 1, but enforcement never occurred because the American Medical Association and other groups opposed the new regulation, saying it was overly burdensome on physicians and labs as well as a threat to patient access.

CMS officials indicated in February that the agency would be rescinding the rule.

The official rescission of the requirement most likely will appear in the proposed Medicare physician fee schedule expected this summer, Glisson said. Physicians and other interested parties then would have the opportunity to comment on the proposal before it is finalized later this year.

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South Dakota approves abortion waiting period

A new South Dakota law will require women seeking abortions to attend a consultation to learn about abortion alternatives and then wait at least 72 hours before they can undergo the procedure.

The law, signed by the governor on March 22, is believed to be the first of its kind to require a three-day waiting period after an initial visit with an abortion provider. The law, which takes effect July 1, also requires that physicians obtain written proof from patients that they sought counseling at a crisis pregnancy center before treatment is provided. Women experiencing medical emergencies are excluded from the law's requirements, but victims of rape or incest are not.

Planned Parenthood Minnesota, North Dakota, South Dakota called the law "an egregious violation of the Constitution" and said it plans to file a lawsuit to stop the statute. South Dakota Gov. Dennis Daugaard's office said the state is prepared to defend the law against any court challenge. Proponents of the law have pledged to raise private funds to help finance the legal defense, according to Daugaard's office.

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HHS can provide Medicaid reform relief to states, report says

Republican lawmakers want the Dept. of Health and Human Services to start granting states waivers to Medicaid eligibility requirements after the release of an independent report that confirms the administration has that power.

The department has the authority to waive requirements for state Medicaid programs established under the health reform law and the most recent economic stimulus package, the Congressional Research Service said in a memo to the Senate Finance Committee in March.

Some states with tight budgets are struggling to meet the maintenance-of-effort provisions that requires states to keep Medicaid eligibility from dropping below levels that were in place at the time the legislation was enacted, said Sen. Orrin Hatch (R, Utah), the Finance panel's chair. He urged HHS Secretary Kathleen Sebelius to waive these requirements for states under financial distress.

"The Medicaid mandates included in Obamacare are crippling state budgets, encroaching on their flexibility to lower Medicaid spending and tying states' hands in targeting scarce resources to the most vulnerable beneficiaries," Hatch said. Sebelius has said cash-strapped states still have options to reduce Medicaid spending without running afoul of the federal requirements.

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