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19.02.2013 Views

CMS-1403-FC personnel as described in §410.33(c). Moreover, we proposed that physician or NPP organizations that do not enroll as an IDTF and meet the provisions at §410.33 may be subject to claims denial for diagnostic testing services or a revocation of their billing privileges. We solicited comments on whether we should consider establishing additional exceptions to the established performance standards in §410.33(g) for physician and NPP organizations furnishing diagnostic testing services. We stated in the proposed rule that while we believe that most physician and NPP organizations utilize nonphysician personnel described in §410.33(c) to furnish diagnostic testing services, we also solicited comments on whether physician or NPPs conduct diagnostic tests without benefit of qualified nonphysician personnel and under what circumstances the testing occurs. While we proposed to apply the IDTF requirement to all diagnostic testing services furnished in physicians’ offices, we stated that we were considering whether to limit this enrollment requirement to less than the full range of diagnostic testing services, such as to procedures that generally involve more costly testing and equipment. We solicited comments about whether the policy should apply only to imaging services or whether it should also include 208

CMS-1403-FC other diagnostic testing services such as electrocardiograms or other diagnostic testing services frequently furnished by primary care physicians. Within the scope of imaging services, we solicited comments about whether the policy should be limited to advanced diagnostic testing procedures which could include diagnostic magnetic resonance imaging, computed tomography, and nuclear medicine (including positron emission tomography), and other such diagnostic testing procedures described in section 1848(b)(4)(B) of the Act (excluding X-ray, ultrasound, and fluoroscopy)). We also solicited comments on what would be appropriate criteria to limit this provision. Finally, since these changes, if adopted, would take time to implement for suppliers that have enrolled in the Medicare program, we proposed an effective date of September 30, 2009, rather than the effective date of the final rule with comment period. For newly enrolling suppliers, we proposed the effective date of this rule which is January 1, 2009. With the enactment of section 135 of the MIPPA legislation and after reviewing public comments, we are deferring the implementation of these proposals while we continue to review the public comments received on this 209

<strong>CMS</strong>-1403-FC<br />

other diagnostic testing services such as<br />

electrocardiograms or other diagnostic testing services<br />

frequently furnished by primary care physicians. Within<br />

the scope of imaging services, we solicited comments about<br />

whether the policy should be limited to advanced diagnostic<br />

testing procedures which could include diagnostic magnetic<br />

resonance imaging, computed tomography, and nuclear<br />

medicine (including positron emission tomography), and<br />

other such diagnostic testing procedures described in<br />

section 1848(b)(4)(B) of the Act (excluding X-ray,<br />

ultrasound, and fluoroscopy)). We also solicited comments<br />

on what would be appropriate criteria to limit this<br />

provision.<br />

Finally, since these changes, if adopted, would take<br />

time to implement for suppliers that have enrolled in the<br />

Medicare program, we proposed an effective date of<br />

September 30, 2009, rather than the effective date of the<br />

final rule with comment period. For newly enrolling<br />

suppliers, we proposed the effective date of this rule<br />

which is January 1, 2009.<br />

With the enactment of section 135 of the MIPPA<br />

legislation and after reviewing public comments, we are<br />

deferring the implementation of these proposals while we<br />

continue to review the public comments received on this<br />

209

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