ACC must bring to the attention of our colleagues the importance of signing or attesting on the anesthetic record contemporaneously with events.  The habit of pre-signing for events such as induction or emergence can result in claims of fraudulent billing.  In previous settlements in California, members of the Department of Anesthesia were cited and their actions recorded in the National Practitioner Data Bank.

Members of the department made it a habit of signing the record in anticipation of events.  Today, with the use of the electronic medical record it is very clear when a provider signs the record in advance of an event and pre-signing is easily discovered.

The OIG will be looking closely at the availability of providers in the operating room in the year to come.  Play it safe and sign for events only when actually present in the course of the case.