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CMS-1403-FC
requirement with a requirement that the group practice
provide in the same building “physician services unrelated
to the provision of DHS on a full time basis.” According
to the commenter, this revision would be consistent with
the physician self-referral law and regulations, would
permit all physician members of a group practice to utilize
the group’s centralized DHS facility (provided that the
facility is located in the same building where the group
provides other physician services), and would permit the
group to bill for all DHS provided in such a facility under
the Medicare physician fee schedule.
Response: We believe that the changes recommended by
the commenters would not guard adequately against potential
overutilization. In addition, we believe that sufficient
flexibility is afforded multi-specialty groups and others
by allowing arrangements to satisfy the requirements of
either the Alternative 1 or the Alternative 2 approach, as
revised.
Comment: One commenter expressed concern that the
provision is more complicated than necessary and, rather
than a definition of “office of the billing physician or
other supplier,” a definition of an “outside entity” is
needed to determine which services would be affected by the
anti-markup provisions. The commenter suggested “outside
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