The Wisconsin Department of Health Services Division of Quality Assurance (“DQA”) has issued DQA Memo 12-012, repealing the statewide variance permitting verbal and telephone orders to be authenticated within 48 hours.
In 2007, CMS established regulations permitting the authentication of verbal orders within 48 hours in the absence of a state law specifying a timeframe. In Wisconsin, Administrative Code section DHS 124.12(5)(b)11 dictated that all verbal and telephone orders must be “authenticated by the prescribing member of the medical staff in writing within 24 hours of receipt.”
Given that the Wisconsin law was significantly more restrictive than the CMS regulations, DQA issued a statewide variance to DHS 124.12 in 2007 to permit authentication of verbal orders within 48 hours, consistent with CMS regulations.
Effective July 16, 2012, CMS eliminated the requirement for authentication of verbal orders within 48 hours and deferred to applicable state laws to establish the authentication timelines. On August 7, 2012, DQA Memo 12-012 repealed the variance and now requires all verbal and telephone orders be authenticated within 24 hours.
DQA has stated it will accept variance requests from hospitals that believe enforcement of the requirement “would result in unreasonable hardship” and wish to request an alternative timeframe for authentication as long as the granting of the variance does not “adversely affect the health, safety or welfare of any patient.”
Hall Render is submitting variance requests to allow authentication within 48 hours on an indefinite basis on behalf of a number of clients. If you would like to be included in this variance request, please contact Anne Ruff at 414-721-0489 or aruff@hallrender.com or your regular Hall Render attorney as soon as possible. Alternatively, variance requests may be submitted directly to DQA per the instructions set forth in DQA Memo 12-012, available here.
If you intend to submit a variance request, please do so as soon as possible. While we expect DQA to be patient in allowing hospitals to adjust to this requirement or seek variances, they have not provided any guidance as to how long variances will be accepted or when enforcement will begin.
If you need any additional information, please contact:
- Robin Sheridan at 414-721-0469 or rsheridan@hallrender.com;
- Christina Severin at 414-721-0468 or cseverin@hallrender.com;
- Anne Ruff at 414-721-0489 or aruff@hallrender.com; or
- Your regular Hall Render attorney.
