Last week, the Wisconsin Department of Health Services, Division of Quality Assurance (DQA) released a memorandum repealing the statewide variance that allowed for authentication of verbal and telephone orders in hospitals within 48 hours. As a result of the repeal, Wisconsin’s 24-hour timeframe applies. An individual hospital may request a variance that would continue to permit authentication within 48 hours.

As of July 16, 2012, regulations promulgated by the Centers for Medicare and Medicaid Services regarding authentication of verbal orders within 48 hours reached their sunset, and the new federal standard defers to state law for determining timely authentication.  DQA’s memorandum outlines the standard in Wisconsin, which requires that all verbal and telephone orders must be authenticated in writing by the prescribing medical staff member within 24 hours of receipt.

The DQA memorandum specifically notes that a hospital may request a variance of the 24-hour timeframe (i.e., requesting a continuation of the 48-hour timeframe). In order to request a variance, the hospital must establish that the variance does not adversely affect the health, safety, or welfare of any patient and that strict enforcement of the 24 hour requirement would result in an unreasonable hardship on a hospital or a patient.