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Response: We thank the commenter for underscoring the importance of the time from Decision to Transfer (order) to the ED departure, one of the numerator components for the measure

Section 1833(t)(14)(H) of the Act provides that additional expenditures resulting from this paragraph shall not be taken into account in establishing the conversion factor, weighting, and other adjustment factors for 2004 and 2005 under paragraph (9) but shall be taken into account for subsequent years

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If moving to every other day doesnt make symptoms worse, that frequency is likely enough