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CMS-1403-FC
from sharing a practice with his or her physician
organization.
Response: We have modified Alternative 1 so that a
physician group will be allowed to hire a part-time
physician who will “share a practice” with that group,
provided that the part-time physician furnishes
“substantially all” (at least 75 percent) of his or her
professional services through the group. Again, in order
to avoid application of the anti-markup payment limitation
under this final rule, billing physicians and other
suppliers have the option of satisfying either the
requirements of Alternative 1 (the “substantially all”
professional services approach), or the requirements of
Alternative 2 (the “site-of-service” approach).
Comment: One commenter suggested that Alternative 1
may be simpler and more effective if we clarify that the
anti-markup provisions apply only when the billing
physician or physician organization generated the referral
for the pathology services. The commenter noted that, in
States that prohibit the corporate practice of medicine,
independent clinical laboratories contract with pathology
groups to perform pathology services. Because such
pathologists have employment or contractual relationships
with both a pathology group and an independent lab, the
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