108 CMR 10.00 and fees for payment shall not apply to the rates of payment to physicians for medical, surgical, anesthesia and X-ray services provided in state institutions by state-employed physicians or physician consultants in state hospitals. Also, 108 CMR 10.00 and fees for payment shall not apply to:

1. (1) Physicians whose contractual arrangements with hospitals and affiliated medical schools involve a salary, compensation in kind, teaching research or payment from any other source resulting in dual compensation for professional, supervisory or administrative services related to patient care.
2. (2) Physicians who serve as interns, residents, fellows or house officers.

3. (3) Physicians who serve as attending, visiting, or supervisory physicians in a hospital, if any of the following conditions exists:

   1. (a) the physician does not customarily bill private patients without insurance under comparable circumstances
   2. (b) the physician is not legally responsible for, or the physician does not control management of the patient’s case with respect to medical, surgical anesthesia or X-ray services
   3. (c) the physician does not perform the medical, surgical, anesthesia or X-ray services
   4. (d) the physician does not meet DVS’s conditions of participation for physicians