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Regardless of what we each think of our personal journey and experience, the reality is the powers that be insist it is a medical condition which requires professional diagnosis and treatment

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Other commentors stated that if this proposal ( is finalized, CMS should provide additional clarification in this final rule around the limitations for when this proposal would be applied and propose any future expansions of the voluntary alignment waiver outside of the contexts of oncology and nephrology through rulemaking

Data availability The datasets generated during and/or analyzed during the current study are available from the corresponding author (e-mail: [email protected]) on reasonable request