News in brief - July 11, 2011

Medicare to rescind lab signature requirement

Physicians and clinical laboratories will not be subject to more stringent paperwork requirements for lab test orders, according to a June 30 proposed rule from the Centers for Medicare & Medicaid Services.

The Medicare agency has proposed rescinding a rule mandating that all orders and requisitions for clinical diagnostic lab tests be signed by the physician. The signature requirement took effect Jan. 1, but CMS decided not to enforce the policy after physicians and laboratories complained the policy could adversely affect patient care. Federal officials indicated early in the year that the mandate would be rescinded.

Organizations representing physicians and labs said the requirement would have increased the paperwork needed to order a test. Labs also would risk not getting paid for running tests based on unsigned orders.

Dozens of lawmakers also had urged CMS to rescind the signature rule.

"In medicine, our goal must be to cure the sick, not create headaches with medical red tape," said Sen. Robert Menendez (D, N.J.). "I'm glad [CMS] 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."

The rule is expected to be finalized after a public comment period ends on Aug. 29.

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Maine data ban case to be reconsidered after Supreme Court ruling

An appellate court decision in Maine preventing the use of physician prescribing information for marketing purposes has been vacated in light of a U.S. Supreme Court decision finding a similar Vermont law unconstitutional.

The Maine ban, upheld by the 1st U.S. Circuit Court of Appeals in 2010, allowed physicians to opt out of having their prescribing data sold to health information firms and drugmakers for marketing.

On June 23, the U.S. Supreme Court ruled a similar ban in Vermont violated constitutional freedom of speech protections. The high court now has requested the 1st U.S. Circuit Court of Appeals' decision be vacated and sent back to the lower court for reconsideration. At this article's deadline, the appellate court had not scheduled its reconsideration of the case.

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Miami doctor gets 20 years in prison for defrauding Medicare

A Miami internist involved in a $23 million Medicare fraud scheme was sentenced to nearly 20 years in prison on June 27, federal officials said.

Rene De Los Rios, MD, had authorized HIV tests and treatments that were medically unnecessary or never performed, according to a statement from the Dept. of Justice. Dr. De Los Rios diagnosed almost all the patients at a facility with the same rare blood disorder in order to maximize payments.

From April 2003 to October 2003, the physician submitted $23 million in Medicare claims for injection and infusion therapies, officials said. The Medicare program paid about $11.7 million in claims.

On April 14, a jury convicted Dr. De Los Rios of one count of conspiracy to commit health fraud and four counts of submission of false claims, the Justice Dept. said. On June 27, a district court judge ordered him to serve 235 months and pay a minimum of $11.7 million in restitution. The exact amount the defendant and other co-defendants involved in the case must pay will be determined at a later date.

Dr. De Los Rios could not be reached for comment.

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