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CMS-1403-FC
1842(n)(1) of the Act. In light of this proposal, we also
requested comments on how to consider locum tenens and
other arrangements under which a physician provides
occasional services outside of his or her physician
organization, as we recognized that circumstances may exist
under which it is beneficial or necessary for a physician
to provide diagnostic testing services to more than one
physician practice.
We proposed a second alternative proposal, which we
designate here as “Alternative 2,” which would maintain
much of the current regulation text, and its “site-of-
service” approach to determining whether a physician
“shares a practice” with the billing physician or other
supplier, that was finalized in the CY 2008 PFS final rule
with comment period. In other words, we reproposed to
apply the anti-markup payment limitation to non-purchased
TCs and PCs that are performed outside the office of the
billing physician or other supplier. We also solicited
comments on whether this is the best anti-markup approach
or whether we should employ a different approach.
Specifically, in Alternative 2, we proposed to amend
§414.50 to: (1) clarify that the “office of the billing
physician or other supplier” includes space in which
diagnostic testing is performed that is located in the same
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