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CMS-1403-FC
overutilization of in-office imaging. A commenter
recommended that we defer to the Congress regarding
concerns of overutilization of diagnostic testing services.
According to the commenter, the directives in MIPPA,
released after the current proposed rule, are much clearer
on this issue. The commenter noted that the Congress did
not amend the anti-markup provision, choosing instead to
direct the agency to develop a demonstration project to
determine the appropriateness of advanced diagnostic
imaging services furnished to Medicare beneficiaries and
require accreditation of advanced diagnostic imaging
suppliers by 2012.
Response: We do not agree with the commenters that
suggested a delayed effective date beyond January 1, 2009
for either the revisions made by the CY 2008 PFS final rule
with comment period or the revisions that we are making in
this CY 2009 PFS final rule with comment period. We have
decided to make the finalized revisions effective as of
January 1, 2009. When we delayed, until January 1, 2009,
the application of the revisions to §414.50 we made in the
CY 2008 PFS final rule with comment period (except with
respect to certain diagnostic testing arrangements
involving anatomic pathology performed in a “centralized
building” for which the revisions were applicable January
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