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January 03, 2008

UPDATE: CMS Delays Revised Anti-Markup Provisions for Certain Services

On January 3, 2008, the Centers for Medicare & Medicaid Services (CMS) published the Final Rule in the Federal Register, delaying until January 1, 2009, the applicability of the anti-markup provisions in 42 C.F.R. 414.50, as revised by the Medicare Physician Fee Schedule final rule for 2008, except with respect to:

  • the technical component of a purchased diagnostic test; and
  • any anatomic pathology diagnostic testing services furnished in space that: (i) is utilized by a physician group practice as a "centralized building" (as defined at 42 C.F.R. 411.351) for purposes of complying with the physician self-referral rules; and (ii) does not qualify as a "same building" under 42 C.F.R. 411.355(b)(2)(i).

CMS also recently announced that the word "except" was inadvertantly omitted from Section III of the Final Rule.  CMS reports that a correction notice will be published shortly.

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About the Author

  • Michael Apolskis is an attorney. In the course of his practice, he works with health care providers, suppliers and companies on a variety of legal and regulatory matters, including Medicare compliance, reimbursement and enforcement matters.

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