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CMS-1403-FC
record), and it documents the beneficiary’s name, date, and
time the beneficiary was received by that facility.
Comment: Several commenters objected to our proposal
to clarify §424.36(a) to state that a provider or supplier
must make “reasonable efforts to locate and obtain the
beneficiary’s signature” before a provider or supplier
could rely upon one of the exceptions set forth in
§424.36(b)(1) through (5).
Response: We are not adopting our proposal because,
having reexamined the issue, we believe that the current
language in §424.36(b)(5) provides adequate protection for
the beneficiary and the Medicare program. Prior to, and
during the course of, the CY 2008 PFS rulemaking, we were
alerted to the fact that some ambulance providers and
suppliers were signing the claim on behalf of the
beneficiary simply because the beneficiary was not able to
sign the claim at the time of transport. We clarified in
the preamble to the CY 2008 PFS final rule with comment
period that signing the claim on behalf of the beneficiary
simply because the beneficiary was not able to sign the
claim at the time of transport was not proper and, further,
that only providers (and not suppliers) are eligible to use
the exception at §424.36(b)(5). Our decision to make an
exception to the requirement that reasonable efforts must
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