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CMS-1403-FC
in his or her own office. This commenter also suggested
that our proposal would discriminate against small groups
that cannot afford to employ a full-time pathologist. The
commenter asserted that full-time pathologists based in
small communities do not have the resources to bill and
collect on their own and working for one group on a part-
time basis is not sufficient.
One commenter stated that it would support Alternative
1 if it was extended to allow a physician to be employed by
or under contract with up to three physicians or physician
organizations. Commenters recommended that the “one
practice” requirement be eliminated so as not to harm small
and mid-sized practices that cannot afford to employ a
full-time pathologist. Two commenters stated that a
physician should be allowed to maintain “two or three”
independent contractor or employee relationships with
physician organizations and be viewed as sharing a practice
with each. In the commenters’ view, this less restrictive
approach would account for different practice situations
while still providing considerable protection against
Medicare program abuse. Another commenter requested that,
in drafting any final rule, we permit physicians to provide
services in rural health or medically underserved areas
without the secondary arrangement precluding the physician
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