decisionhealth Newsletters, Part B News - 2008 Issue 1 (January)
CMS delays controversial anti-markup provision
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Article Overview
This article explains a CMS delay affecting a Medicare anti-markup policy and outlines the limited exceptions that remain in effect. It is relevant to physician groups, pathology-related services, and practices that bill for diagnostic testing arrangements. The discussion also highlights the agency’s concern about ambiguous regulatory wording and the likelihood of future clarifying guidance or rulemaking.
Why This Topic Matters
The timing of this CMS delay affects compliance planning for practices that rely on purchased diagnostic testing or pathology-related arrangements. It is especially important for physician groups and specialty practices watching how Medicare policy changes may affect existing billing structures.
What You Will Learn
- Why CMS postponed implementation of a Medicare anti-markup policy
- Which broad service categories were described as remaining affected during the delay period
- Why certain physician group and pathology-related arrangements drew regulatory attention
- What types of future CMS follow-up the article says may occur
Who Should Read This
- Medical coders
- Coding auditors
- Physician practice managers
- Compliance staff
- Pathology groups
- Specialty medical practices
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