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CMS-1403-FC
evidence of abuse with respect to billed audiology
services, we are not required to demonstrate that fraud or
abuse has occurred in order to finalize our proposals, but
rather we attempt to guard against the potential for
overutilization or patient abuse, and we strive to make
distinctions between specific types of diagnostic services
only when there is a persuasive reason to do so. We are
unpersuaded to make such a distinction here. As noted
above at section II.N.2., and as discussed more fully below
at section II.N.2.h. in response to a comment, we are
deleting references to purchased TCs and PCs from §414.50.
Comment: Commenters expressed concern that the
anti-markup provisions would apply when cardiologists
perform the PC of a diagnostic testing service procedure in
a hospital or other facility, as is often the case for
complex or high risk procedures, because the test is
conducted outside the office of the billing physician.
Commenters asserted that cardiology groups that provide
outreach services in rural areas and are the only providers
of certain cardiac subspecialty services in such areas are
concerned that their provision of hospital-based cardiac
diagnostic tests to rural patients could become financially
impossible under the anti-markup provisions, thereby
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