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CMS-1403-FC
disadvantage nonproblematic arrangements involving
nonprofit multi-specialty groups that have campus-based
treatment facilities (and thus do not perform diagnostic
testing in the same building as where patients are seen)
largely becomes moot, as most such arrangements should be
able to be structured to fit into Alternative 1, or failing
that, Alternative 2.
With respect to our specific solicitations of
comments, we are not revising the meaning of “net charge”
at this time. Moreover, we are not requiring at this time
direct billing instead of permitting reassignment under
certain circumstances; however, we may propose to do so in
a future notice of proposed rulemaking. We considered the
various recommendations commenters offered for the
effective date for our revisions. We have decided to not
deviate from the effective date that is generally
applicable to this final rule with comment period and,
thus, the revisions to §414.50 will become effective on
January 1, 2009.
Finally, we did not propose to make changes to the in-
office ancillary services exception and are not making any
changes to that exception in this final rule; however, we
are aware of the commenters’ concerns and may propose
rulemaking on this issue in the future.
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