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In the CY 2023 PFS final rule (87 FR 69954 through 69956), we excluded new supplemental payments to Indian Health Service/Tribal hospitals and hospitals located in Puerto Rico consistent with our longstanding policy to exclude IME, DSH and uncompensated care payments from ACOs' assigned and assignable beneficiary expenditure calculations

Long-time cigarette smokers: Risk level is directly proportional to smoking frequency and years smoked Both alcohol and tobacco users: Ethanol works as a solvent, which aids in the permeation of carcinogens