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

Medicare's recently finalized anti-markup rule provides a flexible 2 alternative approach to determining whether or not a diagnostic testing arrangement is subject to the anti-markup payment limitation. Both tests measure whether a performing or supervising physician "shares a practice"with the billing physician or other supplier. Although in the 2009 Medicare Final Physician Fee Schedule CMS declined to implement the IDTF enrollment proposals, which would have required any physician or non-physician practitioner furnishing diagnostic testing services to enroll as an IDTF and be subject to most IDTF performance standards, CMS did finalize its earlier proposal to require mobile IDTFs to enroll and bill Medicare directly for the technical component services that they provide. Imaging services providers should be prepared for heightened Medicare auditing activity, as CMS has made permanent and is expanding its Recovery Audit Contractors program.