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CMS-1403-FC instances other than temporary/transient network transmission failures. * * * * * PART 424--CONDITIONS FOR MEDICARE PAYMENT 36. The authority citation for part 424 continues to read as follows: Authority: Secs. 1102 and 1871 of the Social Security Act (42 U.S.C. 1302 and 1395hh). Subpart C--Claims for Payment 37. Section 424.36 is amended by revising paragraphs (a), (b)(6) introductory text, and (b)(6)(ii)(C)(2) to read as follows: §424.36 Signature requirements. (a) General rule. The beneficiary’s own signature is required on the claim unless the beneficiary has died or the provisions of paragraphs (b), (c), or (d) of this section apply. For purposes of this section, “the claim” includes the actual claim form or such other form that contains adequate notice to the beneficiary or other authorized individual that the purpose of the signature is to authorize a provider or supplier to submit a claim to Medicare for specified services furnished to the beneficiary. (b) * * * 1134
CMS-1403-FC (6) An ambulance provider or supplier with respect to emergency or nonemergency ambulance transport services, if the following conditions and documentation requirements are met. * * * * * (ii) * * * (C) * * * (2) The requested information from a representative of the hospital or facility using a secondary form of verification obtained at a later date, but prior to submitting the claim to Medicare for payment. Secondary forms of verification include a copy of any of the following: sheet; (i) The signed patient care/trip report; (ii) The facility or hospital registration/admission (iii) The patient medical record; (iv) The facility or hospital log; or (v) Other internal facility or hospital records. * * * * * 38. Section 424.44 is amended by-- A. Revising the introductory text of paragraph (a). B. Adding paragraph (e). The revision and addition read as follows: 1135
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<strong>CMS</strong>-1403-FC<br />
instances other than temporary/transient network<br />
transmission failures.<br />
* * * * *<br />
PART 424--CONDITIONS FOR MEDICARE PAYMENT<br />
36. The authority citation for part 424 continues to<br />
read as follows:<br />
Authority: Secs. 1102 and 1871 of the Social Security<br />
Act (42 U.S.C. 1302 and 1395hh).<br />
Subpart C--Claims for Payment<br />
37. Section 424.36 is amended by revising paragraphs<br />
(a), (b)(6) introductory text, and (b)(6)(ii)(C)(2) to read<br />
as follows:<br />
§424.36 Signature requirements.<br />
(a) General rule. The beneficiary’s own signature is<br />
required on the claim unless the beneficiary <strong>has</strong> died or<br />
the provisions of paragraphs (b), (c), or (d) of this<br />
section apply. For purposes of this section, “the claim”<br />
includes the actual claim form or such other form that<br />
contains adequate notice to the beneficiary or other<br />
authorized individual that the purpose of the signature is<br />
to authorize a provider or supplier to submit a claim to<br />
Medicare for specified services furnished to the<br />
beneficiary.<br />
(b) * * *<br />
1134