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CMS-1403-FC
a. General comments
Comment: Some commenters were concerned with their
perceived complexity of the anti-markup provisions and
requested that we delay making any revisions to the rule.
A commenter argued that extending the application of the
anti-markup payment limitation only adds another layer of
unnecessary complexity and confusion to an area where
physicians want to provide high quality services in a cost
efficient manner. Some commenters, including a large
medical association, requested that we withdraw the
proposals of this rule, as well as the proposals contained
in the CY 2008 PFS final rule with comment period. In
contrast, one commenter stated that the anti-markup
provisions are consistent with the aforementioned medical
association’s code of ethics, which states that a physician
should not charge a markup, commission, or profit on
services rendered by others. A second commenter noted that
the same medical association and many hospital bylaws
strongly discourage fee-splitting. Other commenters urged
us to not weaken or dilute last year’s important anti-
markup provision.
Response: We believe that the anti-markup provisions
in §414.50, as revised by this final rule with comment
period, are not inordinately complex. We agree that it
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