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CMS-1403-FC
the ordering physician provides generally). Many of the
potentially abusive pod lab arrangements that led to our
extension of the anti-markup provisions to the PC of
diagnostic testing services involved independent contractor
pathologists who performed services in off-site pathology
labs. Those arrangements did not have the type of nexus
with the group practice required under §414.50(a)(2) (that
is, the pod labs were not within the same building in which
the ordering physician provided substantially the full
range of patient care services).
We do agree with the commenter’s analysis of Example 3
given in the proposed rule.
Comment: One commenter requested that, if adopted,
the proposal for Alternative 2 should include detailed
examples that provide clear definitions for several key
terms, including “office of the billing physician or other
supplier,” “conducting and supervising the TC,” and “full
range of services.” The commenter believes that, without
these definitions, our intent will be misconstrued and
subject to potential abuse.
Response: We do not provide a definition for
“conducting and supervising the TC” in the regulation text,
as we believe that the meaning of “conducting” is clear on
its face; that is, the term “conducting the TC” refers to
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