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We considered asking the official to submit their MRF attestation directly to CMS, using a CMS developed template that would provide evidence of the accuracy and completeness of the MRF, and we also considered requiring the hospitals to post a more detailed attestation document that is signed by a senior official on the publicly available website that hosts the MRF

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Poor sleep worsens fatigue, headaches, and stress tolerance

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A stronger note would say: Open bite wound of left hand caused by dog bite, initial treatment provided. That supports both the injury code and the external cause code