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In cases when the patient does not have a written order or referral from their physician/NPP, the POC signature requirement for certifications would still apply, as we proposed at 424.24(c)(5)

of this final rule, we discuss a series of ICRs associated with the Quality Payment Program, including for MIPS and Advanced APMs

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They present unique challenges in diagnosis in that any previous healthcare interaction could affect the individual resistance patterns of pathogens infecting the individual patient and require close contact with public health agencies since resistance patterns are constantly changing, so a much more extensive medical review is required

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