Notice: This CMS-approved document has been submitted - Philips ...

CMS-1403-FC
same-specialty locum tenens arrangements from the anti-
markup provision.
Response: In the CY 2009 PFS proposed rule, we
requested comments on how, under Alternative 1, we could
permit a physician to provide occasional services outside
of his or her physician organization without the secondary
arrangement precluding the physician from sharing a
practice with the physician organization for purposes of
applying the anti-markup provisions. To accommodate such
temporary physician arrangements, we have modified
Alternative 1 so that a physician will be considered to
share a practice with a physician, physician organization,
or other supplier if the physician furnishes at least 75
percent of his or her professional services through that
physician, physician organization, or other supplier.
Thus, the final rule allows a physician to furnish up to 25
percent of his or her professional services through other
arrangements (including for the purpose of acting as a
locum tenens physician) without disqualifying himself or
herself from sharing a practice with his or her primary
physician practice. We believe that our modification
provides assurance that the performing physician has a
sufficient nexus with the billing physician or other
supplier so as to share a practice with such physician or
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