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Many commenters recommended that we further evaluate and refine the stratification scheme to more accurately reflect the resource intensity required for effective advanced primary care delivery by incorporating additional factors, such as the severity of individual conditions, social risk factors beyond QMB status, and other indicators of medical complexity

For 2026 review, the content emphasizes current verification, treatment fit, and patient-safety questions that can be discussed with a qualified provider

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Some Medicare Advantage plans specifically require documentation of failed corticosteroid therapy before authorizing HA products