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64 Clinicians should be aware that while the combination of the nicotine patch and sustained-release bupropion has been approved by FDA, the concurrent use of two NRT products is not FDA-approved for tobacco cessation

Finally, while the service descriptors above are consistent across all three APCM levels because the scope of service elements are consistent across all levels of APCM and the elements that are provided depend on medical necessity and individual patient need, we are proposing that the APCM codes would be stratified into three levels based on certain patient characteristics that are broadly indicative of patient complexity and the consequent resource intensity involved in the provision of these services in the context of advanced primary care

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Further, we propose that the timing of the ACO's reopening request must be consistent with the timeframes specified in 425.315(a)(1)(i) and (ii), respectively, either (i) at any time in the case of fraud or similar fault, or (ii) not later than 4 years after the date of the notification to the ACO of the initial determination of savings or losses for the relevant performance year for good cause