To:  All Medicaid Providers

RE:  Clarification:  Physicians’ Signature Designee
 
This ALERT is to clarify information published in the January 2015 “Provider Insider” regarding the use of a physician designee when signing medical documentation.
 
1. Referral forms must be signed by a licensed practitioner (i.e., physician, physician assistant, or nurse practitioner) if the form contains orders.  
   a. The licensed practitioner writing the order may be a covering physician/Non-Physician Practitioner within the same group of the same specialty using the same medical record.    
   b. The referral must be written to show the Primary Medical Provider on the left and the EPSDT screening provider on the right of the Alabama Medicaid Referral Form 362. 
   c. Signatures must be handwritten or electronic in accordance with Administrative Code Rule No. 560-X-1-.18, Provider/Recipient Signature Requirements.
   d. The medical record must contain the licensed practitioner’s order for the referral (e.g., doctor’s order, progress notes, physician’s impression/treatment plan, etc.) to verify the licensed practitioner’s documentation. 

2. A physician’s designee may sign a referral form only when no orders are written on the form.  Referral forms signed by a designee must contain the designee’s complete and original signature (initials are not acceptable).
3. If the referral is not documented and signed in the medical record by the practitioner, the record may be cited by auditors and the Medicaid funds subject to recoupment.
4. This designee clarification is retroactive to January 1, 2015, and supersedes the information published in the January 2015 “Provider Insider.”

Questions regarding this policy should be directed to: Russell Green, Associate Director, Medical Services Division, at: (334) 353-4783, or email at: Russell.Green@Medicaid.Alabama.Gov.