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As explained in the CY 2025 PFS proposed rule (89 FR 61968-61969), CMS conducts a thorough review of PDE records, which includes the identification of outliers in the quantity dispensed field of PDE records, as part of the Part D payment reconciliation process that occurs between CMS and plan sponsors each year

ConclusionLong-Term Effects: The committee noted increasing evidence suggesting significant longer-term effects on multiple aquatic and shoreline species and communities, including humans, than previously estimated