The Health Law practice at Lamb McErlane led by Chairman Vasilios “Bill” Kalogredis brings an extensive amount of experience representing physicians, dentists, group practices, other health care professionals and health care-related entities.
Lamb McErlane’s areas of concentration are:
Agreements with Hospitals
- Exclusive Service Agreements
- Medical Director Agreements and Call Coverage
- Physician Recruitment Agreements
- Employment Agreements
Anti-Kickback and Stark Compliance
- Anti-Kickback Statute
- The Stark Law
- The False Claims Act
Disciplinary Actions Against Health Care Licensees
- Licensure Issues
- Hearings and Appeals
- Employer Issues
- Employee Issues
- Employment Concerns and Issues
Expert Witness and Alternative Dispute Resolution Services
- Expert Witness Services
- Alternative Dispute Resolution (ADR)
Group Practice Arrangements
- Sick Disability
- Restrictive Covenants
Healthcare Business and Tort Litigation
- Practice Split-Ups
- Restrictive Covenants
- Other Disputes
Medical Staff Privilege and Credentialing Issues
- Sanctions and Hearings
Medicare and Private Insurance Reimbursement and Audits
- Other Medicare Third Party Payers
- Contracts with Accountable Care Organizations
- Accountable Care Organizations
- Financial and Medical Implications
Practice Sales, Purchases and Mergers
- Sales and Purchases
- Legal, Practical and Business Advice
Professional Entity Formation
Shareholder Agreements and Operating Agreements
Medicare’s Signature Requirements
It can be a headache for providers to comply with the lengthy checklist of requirements for submitting a claim to Medicare. One of those requirements is obvious but often forgotten—a signature. Medicare requires signatures on submitted medical records including notes, lab results, clinical observations, and orders. An absent signature can result in a denied reimbursement or a recouped overpayment.
A provider can remedy forgotten signatures on most medical records by submitting an attestation statement. The statement must itself be signed, dated, and provide adequate information to identify the patient. Note that some jurisdictions may have additional requirements or restrictions as to such statements.
If an order is missing a signature, however, an attestation statement may not be sufficient. This is because Medicare requires a valid order to be contemporaneously signed. For certain unsigned orders, Medicare may accept signed progress notes evidencing an intent to order.
If the signature on a medical record is present but illegible, then Medicare allows providers to submit an attestation statement—as with other medical records—or signature log. A signature log is a typed listing of physicians and non-physician providers along with their corresponding signatures, which a provider can create and submit to Medicare at any time.
Even when a signature is present and legible, it can be inadequate if it is electronic. Medicare permits electronic signatures only when compliant with additional requirements. For example, the software providing the electronic signature must have protections against modification. Medicare places the responsibility of authenticating the attested information on the electronic signer and the provider.
Given the complexity of this seemly simple checklist item, it is important for providers to speak with an attorney, and often their insurers, for additional guidance.
For more information, see CMS’s May 2018 fact sheet here.
Vasilios (“Bill”) J. Kalogredis, Esquire is Chairman of Lamb McErlane’s Health Law Department. Bill has been practicing health law for over 40 years, representing exclusively physicians, dentists, group practices, other health care professionals and health care-related entities.
Andrew Stein is an associate at Lamb McErlane PC. He concentrates his practice at the intersection of health law and business law. He represents individuals and businesses with a primary focus on licensed medical and dental professionals, medical and dental practices, and other health care entities.