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Additionally, at 419.46(e)(3), 419.95(g)(3), and 416.310(d)(3), we proposed that we may grant an ECE to one or more hospitals, REHs, or ASCs that have not requested an ECE if we determine that: a systemic problem with a CMS data collection system directly impacted the ability of the hospital, REH, or ASC to comply with a quality data reporting requirement, or that an extraordinary circumstance has affected an entire region or locale

Mild gastrointestinal effects flatulence, loose stools are occasionally reported and typically self-resolve

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The mechanistic case is strong

Hyperglycaemia occurs in 1540% of patients with MACS, and the risk of diabetes increases with the degree of cortisol excess, age, and adrenal adenoma size [176]

We explained that the proposed timeframe (within 30 calendar days of the date of notice of imposition of the CMP) would provide a hospital ample opportunity to elect whether to exercise its option to waive a hearing