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Standards of Care II

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Recent developments and key legal issues impacting diagnostic imaging services, part 2.

Adrienne Dresevic¹, Carey F Kalmowitz

¹Wachler & Associates, P.C., USA. adresevic@wachler.com

Radiology Management

|July 29, 2009

Summary

Medicare's new anti-markup rule offers two ways to check diagnostic testing compliance. It also requires mobile independent diagnostic testing facilities to enroll and bill Medicare directly, impacting imaging providers.

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Area of Science:

Healthcare Policy
Medical Billing
Diagnostic Services

Background:

The Centers for Medicare & Medicaid Services (CMS) has updated its anti-markup rule for diagnostic testing.
Previous proposals for Independent Diagnostic Testing Facility (IDTF) enrollment were not implemented in 2009.
The rule aims to clarify payment limitations for diagnostic testing arrangements.

Purpose of the Study:

To explain the new flexible alternative approaches for determining anti-markup payment limitations.
To inform providers about the implications of the finalized rule, particularly for mobile IDTFs.
To alert imaging services providers about increased Medicare auditing and the expansion of the Recovery Audit Contractors program.

Main Methods:

Analysis of Medicare's finalized anti-markup rule.
Review of physician practice "shared practice" criteria for billing.
Examination of CMS's decisions regarding IDTF enrollment and billing requirements.

Main Results:

A flexible, two-alternative approach is now available to assess diagnostic testing arrangements for anti-markup rules.
Mobile IDTFs must now enroll and bill Medicare directly for technical component services.
CMS has made permanent and is expanding its Recovery Audit Contractors program, indicating increased auditing.

Conclusions:

Healthcare providers, especially in diagnostic testing and imaging, must adapt to new compliance requirements.
Direct billing by mobile IDTFs for technical components is now mandatory.
Expect increased scrutiny and auditing from Medicare.