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As noted in the CY 2025 PFS proposed rule (89 FR 62052 through 62053), the Prostate Cancer measure had a mean reliability of 0.68 at the TIN level and 0.62 at the TIN-NPI level

(2) Drugs and biologicals that meet the definition of a Part D rebatable drug but, for the entire duration of the applicable period, are excluded from the definition of covered outpatient drugs as defined in section 1927(k)(2)-(4) of the Act and 447.502 of this chapter, as determined by CMS through consultation with Medicaid Drug Rebate Program staff and review of the Medicaid Drug Programs system

Providers typically evaluate the trend over multiple weeks before making any dosing changes

It is linked to an increased risk of gastrointestinal cancer or polyps