Marty, I don't understand why Medicare/Medicaid would like to see lab requisitions. I'm assuming this is because you are drawing labs onsite, and are you also running the labs onsite too?
There are other posts and also advice from Angel Support recommending the lab orders be reconciled, because they can slow down the system when in high numbers. So reconciling them would make sense.
When you send the order to your lab user, they can save the order and it's stored in their chart. Thus providing record of the lab order. But if you are drawing labs and processing the labs onsite, keeping the hard copy paper lab order would make sense, especially if you are getting audited frequently.