Industry observers say the CMS missed an opportunity to prevent physician self-referral when it decided to drop a provision in the final rules of the Medicare Physician Fee Schedule and Hospital Outpatient Perspective Payment System for 2009 that requires physician groups to enroll as independent testing facilities. CMS said provisions in the Medicare Improvements for Patients and Providers Act of 2008, which requires certain facilities to gain accreditation by 2012, already address this issue.

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