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This mechanism becomes clinically important when using high-dose oral supplements (typically 1000 micrograms or more), as it can provide adequate absorption even when the intrinsic factor pathway is impaired

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Consistent with our methodology established in the FY 2013 IPPS/LTCH PPS final rule (77 FR 53687 through 53688), we believe that it is appropriate to include adjustments for the Hospital Readmissions Reduction Program and the Hospital VBP Program (established under the Affordable Care Act) within our budget neutrality calculations