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We are concerned that such SAHS billing activity, should it occur in CY 2024 or later, would inflate Medicare Parts A and B payment amounts and affect Shared Savings Program calculations, including: Performance year reconciliation calculations, including expenditures for each ACO's assigned beneficiaries for the calendar year that has SAHS billing activity, the national-regional blended update factor used to update the benchmark for ACOs beginning an agreement period before January 1, 2024 (refer to 425.601(b)), the three-way blended update factor used to update the benchmark for ACOs beginning an agreement period on January 1, 2024 and in subsequent years (refer to 425.652(b)), and factors based on ACO participant revenue to determine the loss recoupment limits for ACOs participating under two-sided models of the BASIC track (Levels C, D, E) (refer to 425.605(d))

CMS may impose a civil money penalty on a manufacturer that fails to pay the rebate amount set forth in 427.301(a) on a Part B rebatable drug identified at 427.101, by the payment deadline as set forth in 427.505(a) for such drug for such applicable calendar quarter

Due to the discomfort and potential irritation that a saliva-dip mixture can cause, users will usually spit the excess moisture out

Tobacciana associated with nasal snuff use include snuff containers, whether totally sealable (such as snuff bottles, snuff boxes, snuff horns, snuff jars, and snuff tubes (snuff cylinders)) or containing an opening from which to take snuff (such as snuff bullets and snuff ejectors)