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Additionally, the nominator believes that the payment reduction for this code family has the potential to diminish the specialist workforce trained to perform these procedures, thereby presenting future challenges in patient care and access to specialized services

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In the November 2018 final rule (83 FR 59959 through 59964), we finalized changes to the beneficiary voluntary alignment policies (refer to 425.402(e)) to revise the requirements previously established for the voluntary alignment process

however, CMS would retain discretion over whether to reopen payment determinations after reviewing information provided in such requests