The final 2011 Medicare physician fee schedule rule requires a physician’s or qualified nonphysician practitioner’s (NPP) signature on requisitions for clinical diagnostic laboratory tests paid under the clinical laboratory fee schedule effective January 1, 2011. In December 2010, CMS announced it was not going to enforce this policy during the first quarter of 2011 while it conducted provider education and outreach activities. After further consideration, CMS has decided “to focus for the remainder of 2011 on changing the regulation that requires signatures on laboratory requisitions because of concerns that physicians, NPPs, and clinical diagnostic laboratories are having difficulty complying with this policy.”