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CMS-1403-FC
Physician A furnishes at least 75 percent of her services
through Physician Organization B, and furnishes 25 percent
of her professional services through Physician C and
Laboratory Supplier D. Under this example, Physician A
would be considered to be sharing a practice with Physician
Organization B.
Revised §414.50(a)(2)(ii) provides that the
“substantially all” requirement is satisfied if the billing
physician or other supplier has a reasonable belief, when
submitting a claim, that: (1) the performing physician has
furnished substantially all of his or her professional
services through the billing physician or other supplier
for the period of 12 months prior to and including the
month in which the service was performed; or (2) the
performing physician will furnish substantially all of his
or professional services through the billing physician or
other supplier during the following 12 months (including
the month the service is performed).
Comment: In response to our request for comments on
how to address locum tenens relationships under Alternative
1, several commenters recommended that the locum tenens
relationships should not count in calculating whether a
physician shares a practice with another physician or other
supplier. Another commenter suggested that abuse of locum
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