CMS allows verbal consent to sign on behalf of suspected or confirmed COVID-19 patients

The Centers for Medicare and Medicaid Services allows providers to obtain verbal consent to sign when contamination of a stylus or recording device is of concern


EMS responders at every level have many questions about how legal and clinical documentation issues will play out in the COVID-19 pandemic. Do the same standards of care apply? What communications are allowed under HIPAA? 

In a free webinar, national EMS attorneys Doug Wolfberg and Steve Wirth, and NAEMT President Matt Zavadsky will address these and other COVID-19 concerns, and answer your questions.

Register now for the webinar (Friday, April 17, 2 p.m. ET/11 a.m. PT), to learn more about documenting clinical assessment, infection control, medical necessity and patient disposition, as well as patient signature alternatives.

By Laura French

BALTIMORE — The Centers for Medicare and Medicaid Services (CMS) have confirmed that EMS providers may sign off on claim submissions on behalf of suspected or confirmed COVID-19 patients with verbal consent under specific circumstances.

CMS wrote in a frequently asked question response that ambulance crewmembers may get verbal permission from a patient to authorize submission of Medicare claims when there are concerns about contamination of an electronic pen, stylus or electronic recording device, and that the verbal consent should be documented in the patient care report. 

The Centers for Medicare and Medicaid Services (CMS) will accept signatures made on behalf of suspected or confirmed COVID-19 patients by EMS providers with verbal consent when contamination of a stylus or electronic recording devices is of concern. (Photo/National Ambulance Service)
The Centers for Medicare and Medicaid Services (CMS) will accept signatures made on behalf of suspected or confirmed COVID-19 patients by EMS providers with verbal consent when contamination of a stylus or electronic recording devices is of concern. (Photo/National Ambulance Service)

The agency recommended following the Centers for Disease Control's Interim Guidance for Emergency Medical Services Systems and 911 Public Safety Answering Points for COVID-19 in the United States in order to disinfect equipment when possible, but said EMS providers can still sign on behalf of suspected or confirmed COVID-19 patients with verbal consent when it is impractical or impossible to disinfect the device after it is used, noting that some surfaces may be more difficult to clean. 

"CMS has determined that there is good cause to accept transport staff signatures under these circumstances," the response stated. 

National EMS industry law firm Page, Wolfberg & Worth (PWW) and other industry groups had previously requested relief from signature rules for Assignment of Benefits signatures from suspected or confirmed COVID-19 patients due to contamination risks, according to a PWW statement. 

When verbal permission is used to sign off on claims, PWW said providers should be sure to include in their patient care report both that the patient was known or suspected to have COVID-19 and that the crew obtained verbal consent to sign on behalf of the patient, for example, "Patient was a suspected (or known) COVID-19 patient and gave us verbal consent to sign on the patient's behalf." 

PWW also reminded providers to complete their PCRs after proper removal of PPE and following the CDC's hand hygiene guidelines. 

Read the full FAQ response here (pg. 16)

 

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