Medicare Compliance & Reimbursement

Signing clinical records electronically too soon could cost you.

Less than a month after CMS gave nursing facilities the okay to sign the Minimum Data Set electronically, the agency is second-guessing its guidance, so many providers are putting their digital plans on hold.

At the Sept. 28 SNF/Long-Term Care Open Door Forum, providers and CMS officials wrangled about just what constituted readiness to sign electronically. At the crux of the issue: whether a facility had to do all clinical documentation electronically to qualify for the privilege of signing the MDS electronically, or if only the MDS had to be an electronic record.

Some providers in New York have reportedly caught flak from their fiscal intermediaries about clinical documentation coming in with digital John Hancocks, according to a caller from the Jewish Home and Hospital in New York City.

In S&C-04-46, issued Sept. 9, CMS states that long-term care providers "...may implement/accept the use of electronic signatures for their clinical record documentation including the Minimum Data Set if this is permitted by state and local law and authorized by the long-term care facility's policy."

"We'll have to get back to you with a clarification," allowed CMS' Sheila Lambowitz, who addressed callers' concerns regarding e-signatures.

Savvy long-term care providers may want to wait, suggest some experts. Attempting to streamline the process with electronic signatures before further guidance from CMS may just have the opposite affect.