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CMS attempted to phase out expenditure authority for DSHP in Section 1115 Demonstrations in 2017 and in 2022, limited the size and scope of DSHP with required state contributions, a cap on the total amount of federal and state DSHP expenditure authority, and time limits for federal funds

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We identified only two cases of invasive melanoma in male patients in the fifth and sixth decade of life, demonstrating that this neoplasm is very rare in the mouth, particularly amelanotic melanoma.8 Immunohistochemistry for S100 and melan A was important for diagnostic confirmation and differential diagnosis