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Tier 1 demonstrates model comprehensiveness: Tier 1: 5 institutions Tier 2: 16 institutions Tier 3: 13 institutions Tier 4: 17 institutions Below are results from the 2025 policy assessment and demonstrates the percentage of the 51 policies that include an item versus not

Section 1895(b)(3)(D)(ii) of the Act requires the Secretary, at a time and in a manner determined appropriate, through notice and comment rulemaking, to provide for one or more permanent increases or decreases to the standard prospective payment amount (or amounts) for applicable years, on a prospective basis, to offset for such increases or decreases in estimated aggregate expenditures, as determined under section 1895(b)(3)(D)(i) of the Act