Filling the need for trusted information on national health issues, Juliette Cubanski The Centers for Medicare & Medicaid Services maintains a more complete list of coronavirus waivers and flexibilities that have been exercised since early 2020; some state actions to respond to the emergency may have expiration dates that are not tied to the end of the federal emergency declarations. lock In contrast to its holding in the companion. All rights reserved. The U.S. Supreme Court in January allowed the vaccine mandate rule to take effect nationwide, and a federal judge later dismissed a Texas challenge to the mandate. This two-phase plan includes criteria for: definitions and thresholds for non-compliance. Biden's vaccine mandates have seen few legal victories. Like the CMS Vaccination Mandate, state vaccination mandates may be limited to workers at certain healthcare facilities. . Plans may limit reimbursement to no less than the actual or negotiated price or $12 per test (whichever is lower). . CMS has issued many blanket waivers and flexibilities for health care providers that are in effect during the COVID-19 PHE to prevent gaps in access to care for beneficiaries impacted by the emergency. As a result of the Courts decision, most Medicare- and Medicaid-certified providers and suppliers must now proceed to develop and implement policies and procedures under which all staff are vaccinated for COVID19. . Termination is the last resort after the provider has been given sufficient opportunities to reach full compliance. Learn about COVID-19 vaccine guidance for moderately or severely immunocompromised patients. . means youve safely connected to the .gov website. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). Organizations with higher than a 90% rate (i.e. Your patients may know these as "updated COVID-19 vaccines": Pfizer-BioNTech: all patients 6 months - 4 years old. Washington Offices and Barbara Jordan Conference Center: 1330 G Street, NW, Washington, DC 20005 | Phone 202-347-5270, www.kff.org | Email Alerts: kff.org/email | facebook.com/KaiserFamilyFoundation | twitter.com/kff. Notably, the Courts ruling inNFIBdidnothave any effect on the enforcement of another federal COVID-19 employer regulation: OSHAs so-called Healthcare ETS. OSHA published the Healthcare ETS as an interim final rule on June 21, 2021 to specifically protect healthcare and healthcare support service workers from occupational exposure to COVID-19 in settings where people with COVID-19 are reasonably expected to be present.To this end, the Healthcare ETS enumerated various measures that applicable employers had to implement to reduce transmission of COVID-19 in healthcare workplaces, including support for COVID19 vaccination for employees through reasonable time off and paid leave protections. Last day of the first calendar quarter beginning one year after end of 319 PHE. The CAA also phases down the enhanced federal funding through December 31, 2023. On Jan. 13, 2022, the U.S. Supreme Court ruled that the COVID-19 vaccine mandate issued by the Centers for Medicaid and Medicare (CMS) is allowed to move forward for healthcare workers in the U.S. 216-444-0141 Plans can set up a network of providers, such as pharmacies or retailers, to provide OTC tests for free rather than having patients to pay up front and submit claims for reimbursement, but the coverage requirement applies whether or not consumers get tests from participating providers. CMS Enforcement Penalties for Non-Compliance. No longer tied to 319 PHE; provisions in the IRA require Medicaid and CHIP programs to cover all Advisory Committee on Immunization Practices (ACIP)-recommended vaccines for adults, including the COVID-19 vaccine, and vaccine administration without cost sharing as a mandatory Medicaid benefit (coverage of ACIP-recommended vaccines for children in Medicaid and CHIP was already required). COVID-19 Section 1115 demonstration waivers allow HHS to approve state requests to operate Medicaid programs without regard to specific statutory or regulatory provisions to furnish medical assistance in a manner intended to protect, to the greatest extent possible, the health, safety, and welfare of individuals and providers who may be affected by COVID-19. OSHA later withdrew the General ETS on January 26, 2022. @rachanadixit, By Rachana Pradhan CMS is committed to ensuring Americas healthcare facilities respond effectively in an evidence-based way to the Coronavirus Disease 2019 (COVID-19) Public Health Emergency (PHE). Disaster-Relief State Plan Amendments (SPAs) allow HHS to approve state requests to make temporary changes to address eligibility, enrollment, premiums, cost-sharing, benefits, payments, and other policies differing from their approved state plan during the COVID-19 emergency. Health plans must cover up to 8 free OTC at-home tests per covered individual per month, and no physicians order or prescription is required. Secure .gov websites use HTTPSA The Henry J. Kaiser Family Foundation Headquarters: 185 Berry St., Suite 2000, San Francisco, CA 94107 | Phone 650-854-9400 Section 1135 waivers allow the Secretary of the Department of Health and Human Services to waive certain program requirements and conditions of participation to ensure that Medicare beneficiaries can obtain access to benefits and services. The mandate requires health-care workers at facilities paid by Medicare and Medicaid to be fully vaccinated or they risk loss of funding. 2023 Kaiser Family Foundation. Opens in a new window. Previously, the enhanced funding was set to expire on the last day of the calendar quarter in which the 319 PHE ended. On January 3, the FDA amended the Pfizer-BioNTech COVID-19 vaccine (PDF)EUA to authorize the use of third pediatric doses (orange cap) for 511-year-old solid organ transplant patients or patients with a similar level of immunocompromise. Your patients may know these as updated COVID-19 vaccines: Timeline of Previous COVID-19 Vaccine EUAs. Because the federal government purchased theinitial supply of COVID-19 vaccines, this toolkit primarily focuses on coverage for administering the vaccine. Let us know at KHNHelp@kff.org, Hospital Investigated for Allegedly Denying an Emergency Abortion After Patient's Water Broke, Medicare Fines for High Hospital Readmissions Drop, but Nearly 2,300 Facilities Are Still Penalized, This Open Enrollment Season, Look Out for Health Insurance That Seems Too Good to Be True, What Looks Like Pot, Acts Like Pot, but Is Legal Nearly Everywhere? lock As a result of the Courts decision, most Medicare- and Medicaid-certified providers and suppliers must now proceed to develop and implement policies and procedures under which all staff are vaccinated for COVID19. Group health plans and individual health insurance plans are required to cover COVID-19 tests and testing-related services without cost sharing or prior authorization or other medical management requirements. , Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in San Francisco, California. You can support KHN by making a contribution to KFF, a non-profit charitable organization that is not associated with Kaiser Permanente. Percentages less than 100% are considered non-compliant and these facilities will receive an enforcement notice. Businesses opting for their own mandates can take steps to minimize claims and exposure. Thus, the Healthcare ETS was never a vaccination mandate per se. Follow @jcubanski on Twitter In addition to COVID-19 vaccination mandates for healthcare workers, another iteration of vaccination mandates may apply to physicians: COVID-19 vaccination requirements applicable to employers. Brad Little was among 25 Republican governors who told President Joe Biden in a December letter that, by keeping ineligible people on the Medicaid rolls, the mandate was "negatively . And third, they may be subject to COVID-19 vaccination mandates as gatekeepers for other individuals seeking a physicians certification for a vaccination exemption. Its important to note, not everything on khn.org is available for republishing. If the pandemic is declared over, I dont see how rules designed for emergencies would stay in place.. Apr 06, 2022 - 03:59 PM The Centers for Medicare & Medicaid Services today released a memorandum and provider-specific guidance on complying with its interim final rule requiring COVID-19 vaccinations for workers in most health care settings, including hospitals and health systems, that participate in the Medicare and Medicaid programs. To request permission to reproduce AHA content, please click here. An official website of the United States government. CMS updates COVID-19 vaccination guidance for health care providers Oct 27, 2022 - 03:24 PM The Centers for Medicare & Medicaid Services yesterday updated its COVID-19 guidance pertaining to vaccination requirements for health care providers. The extent to which any mandate will apply, if at all, to a physician will turn on myriad factors, including the state where the physician practices, the physicians specialty, the clinical setting of the physicians practice, and the size and structure of the physicians practice as a business and employer. To this end, the Healthcare ETS enumerated various measures that applicable employers had to implement to reduce transmission of COVID-19 in healthcare workplaces, including support for COVID19 vaccination for employees through reasonable time off and paid leave protections. The vaccine mandates fate has been in flux since federal courts in Louisiana and Missouri agreed with Republican-led states that the CMS likely exceeded its statutory authority, pausing enforcement of the rule in November. CMS Inpatient Prospective Payment System (IPPS) Rule Long-Term Care Hospital (LTCH) Compare Inpatient Rehabilitation Facility (IRF) Compare Operational Guidance for reporting HCP COVID-19 Vaccination Data - March 2022 [PDF - 300 KB] Tips for submitting HCP COVID-19 Vaccination Data - March 2022 [PDF - 250 KB] Training An official website of the United States government While a less-dire public health situation could, in theory, pull a more conservative justice over to the other side, the court will not revisit the same case anytime soon unless the facts significantly change, Hodge said. It can be republished for free. On August 19, 2022, the FDA amended the Novavax COVID-19 vaccine, AdjuvantedEUA to authorize the use for all patients 1217 years old. The Biden administration is considering a Republican proposal to strike the COVID-19 vaccine mandate for the U.S. military, a development that signals future possibility of reversal of the same . Phase 2 focuses on getting all staff members vaccinated with their second or final vaccine dose (e.g.,for single shot vaccines), while accommodating/granting protectedexemptions and delays due to medical issues. It is rare that the public health criteria change so rapidly, but welcome to Covid-19.. CMS declined to answer several questions about the Idaho situation. website belongs to an official government organization in the United States. She works closely with physicians and other healthcare professionals, along with various healthcare businesses, in a wide range of corporate, transactional, regulatory, and licensure matters.She may be reached at AMehdi@spencerfane.com. This brief provides an overview of the major health-related COVID-19 federal emergency declarations that have been made, and summarizes the flexibilities triggered by each in the following areas: This is not meant to be an exhaustive list of all federal policy and regulatory provisions made in response to COVID-19 emergency declarations. Physicians should be mindful of how these mandates and even anti-mandates may apply distinctly to them as healthcare workers, employers, and exemption gatekeepers. CMS is committed to working with states to ensure continuity of coverage for eligible individuals, including those for whom the Medicaid agency receives returned mail, Bruce Alexander, director of CMS office of communications, said in a written statement to KHN. And so thats where they said, OK, well, you need to reinstate those individuals.. By July, the state Medicaid agency had reinstated benefits for 6,400 people the state couldnt get hold of. Alert - AHCA Data Request [192KB PDF] Alert - New COVID-19 Guidance for Health Care Practitioners [194KB PDF] Alert - Update on Biden Administration Vaccine Mandate [180KB PDF] CMS appreciates the states efforts to come into compliance, Sarah OConnor, a CMS official, wrote on Aug. 18 of last year. Your membership has expired - last chance for uninterrupted access to free CLE and other benefits. According to the batch of emails obtained by KHN, Idaho in March 2022 did change the states procedures after discussions with CMS. To contact the reporter on this story: Allie Reed in Washington at areed@bloombergindustry.com, To contact the editors responsible for this story: Cheryl Saenz at csaenz@bloombergindustry.com; Brent Bierman at bbierman@bloomberglaw.com. On January 13, the Supreme Court allowed the Centers for Medicare and Medicaid Services' (CMS) mandate requiring 10.4 million health care workers to be vaccinated against COVID-19 to go into effect, while blocking an Occupational Safety and Health Administration (OSHA) rule that would have required 84.2 million employees of large employers to be either vaccinated or masked and tested weekly. It is at least possible that OSHA could pursue amore stringentapproach and adopt a COVID-19 vaccination mandate in the healthcare sector, potentially reaching those healthcare employers not subject to the CMS Vaccination Mandate a possibility theNFIBdecision leaves open. As more COVID-19 vaccines obtain formal approved status with the U.S. Food and Drug Administration and more information becomes known about COVID-19 vaccines, physicians should stay informed of emerging scientific literature regarding the clinical risks and benefits of vaccination for the patient populations whom they treat. Evaluating Compulsory Covid-19 Vaccination Mandates: Defining 'Referral' in the Anti-Kickback Statute, American Bar Association 2023 by the American Hospital Association. At the federal level, the Centers for Medicare & Medicaid Services (CMS) issued a COVID-19 vaccination mandate in the form of an interim final rule published on November 5, 2021 (the CMS Vaccination Mandate). Thank you for your interest in supporting Kaiser Health News (KHN), the nations leading nonprofit newsroom focused on health and health policy. The ongoing public debate over federal and state mandates for vaccination against COVID-19 has reached all corners of the economy and society. means youve safely connected to the .gov website. The Centers for Medicare and Medicaid Services (CMS) published their federal vaccine mandate interim final rule with comment period (IFC) on November 4th. Karen Pollitz , and "At this point in the pandemic, the case for vaccine mandates is much weaker than it was in 2021," she adds. Enrollees receive coverage of coronavirus testing, including at-home, and COVID-19 treatment services without cost sharing. It is at least possible that OSHA could pursue a, In some states, moreover, physicians may have to contend with, For example, the CMS Vaccination Mandate includes a medical exemption for individuals who obtain documentation confirming recognized clinical contraindications to COVID-19 vaccines that is signed by a licensed practitioner, such as a physician, who is not the individual requesting the exemption, and who is acting within their respective scope of practice as defined by, and in accordance with, all applicable State and local laws.. During the first two years of the covid-19 pandemic, while the federal government was trying to prevent people on Medicaid from losing health coverage, Idaho dropped nearly 10,000 people from the safety-net program. An official website of the United States government Medicare Part D plans (both stand-alone drug plans and Medicare Advantage drug plans) must provide up to a 90-day (3 month) supply of covered Part D drugs to enrollees who request it. And, the immune response following COVID-19 vaccination may differ for these patients. In these cases, physicians should be prepared to deny the exemption request if the medical justification is lacking. Under the General ETS, OSHA required employers with a total of 100 or more employees to have a policy mandating COVID-19 vaccination for all employees, with certain exceptions. The CMS Vaccination Mandate was the target of immediate legal challenges, which culminated with the U.S. Supreme Court on January 13, 2022 ruling in. ( Those who do not receive their vaccinations and who do not have an approved exemption will be placed on an unpaid leave of absence. Americans can getvaccines purchased with U.S. taxpayer dollarsat no cost. The emails, sent last spring and summer, detail Idahos rationale for the terminations, CMS concerns, and the states efforts to restore benefits. For the first two years of the pandemic, when Idaho received returned mail with an out-of-state forwarding address or no forwarding address possibly indicating the enrollee no longer lived in Idaho Leach said state officials would call them. The vaccine remains available under EUA, including: Patients who are moderately or severely immunocompromised (have a weakened immune system) are at increased risk of severe COVID-19 illness and death. Ultimately, however, employers were spared from having to make the vaccination-or-testing choice because the U.S. Supreme Court stayed enforcement of the General ETS on January 13, 2022. This latter type of mandate potentially may apply to physician practices as businesses that employ personnel who must receive a COVID-19 vaccine. Tag: cms vaccine mandate Federalizing Public Health February 28, 2023 The Petrie-Flom Center Staff Leave a comment By Elizabeth Weeks The most promising path forward in public health is to continue recognizing federal authority and responsibility in this space. It shows how easily state bureaucracies can disenroll people they shouldnt be disenrolling, leaving those people in financial and medical jeopardy. CMS is providing guidance and survey procedures for assessing and maintaining compliance with these regulatory requirements. It's time to renew your membership and keep access to free CLE, valuable publications and more. CMS Reduces COVID-19 Vaccine Mandate Surveys and Rescinds Surveyor Vaccination Requirements Thursday, June 23, 2022 In two recent memoranda, the Centers for Medicare and Medicaid. COVID-19 vaccination mandates comprise a patchwork of continually developing federal, state, and private-sector requirements, some of which have prompted lawsuits, including the recent Supreme Court cases, challenging the validity of such mandates. . Second, they may be subject to COVID-19 vaccination mandates as employers of other clinical and non-clinical staff. CMS Vaccine Mandate. According to CMSguidance, "Facilitystaff vaccination rates under 100 percent constitute noncompliance under the rule,". The guidance in this memorandum does not apply to the following states at this time: Alabama, Alaska, Arizona, Arkansas, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Mississippi, Missouri, Montana, Nebraska, New Hampshire, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Texas, Utah, West Virginia and Wyoming. In meetings with CMS, Idaho officials were told the state could not kick people off if it didnt make physical contact, Shane Leach, administrator of the Division of Welfare at Idahos Department of Health and Welfare, recounted in correspondence with CMS. Physicians should continue to monitor these regulatory developments and assess their impact from an employer standpoint. Surveyors in these states should not undertake any efforts to implement or enforce the IFC. It did so not because of the outcome of a legal challenge, as it did with its withdrawal of the General ETS after, OSHA strongly suggested that additional rulemaking is forthcoming, stressing that the danger faced by healthcare workers continues to be of the highest concern and measures to prevent the spread of COVID-19 are still needed to protect them., For example, the Healthcare ETS created an exception to its requirements for personal protective equipment (PPE), physical distancing, and physical barriers for vaccinated employees in well-defined areas where there is no reasonable expectation that any person with suspected or confirmed COVID-19 will be present . Finally, COVID-19 vaccination mandates may apply to physicians in an indirect, yet still significant, manner: as the gatekeepers charged with determining whether other individuals qualify for a medical exemption to an otherwise applicable vaccination mandate. On May 5, 2022, the FDA limited the authorized use of the Janssen COVID-19 vaccine to: On March 29, 2022, the FDA amended EUAs to authorize the use of second booster doses as follows: On January 31, 2022, the FDA approved the Moderna COVID-19 vaccine, marketed as SPIKEVAX, for the prevention of COVID-19 disease in patients 18 years and older. All Rights Reserved. On Jan. 27, CMSdetailed to health agenciesin all states the minimum theyll need to do to reach a Medicaid recipient who hasnt responded to a mailed form: Before ending benefits, a state must try to obtain up-to-date contact information and attempt to reach the person through at least two means, such as by mail, phone, email or text message, if those means are available. Idaho Dropped Thousands From Medicaid in the Pandemics First Years, (Eric Harkleroad / KHN illustration; Getty Images). .gov Previously, these provisions were set to expire on the last day of the calendar quarter in which the 319 PHE ended. If a story is labeled All Rights Reserved, we cannot grant permission to republish that item. Official websites use .govA Physicians should be aware of these different applications as healthcare workers, as employers, and as exemption gatekeepers as COVID-19 vaccination mandates continue to evolve. While it was in effect, the Healthcare ETS didnotincludemandatoryvaccination on its list of COVID-19 mitigation measures. The Centers for Medicare & Medicaid Services today released a memorandum and provider-specific guidance on complying with its interim final rulerequiring COVID-19 vaccinations for workers in most health care settings, including hospitals and health systems, that participate in the Medicare and Medicaid programs. On Jan. 30, 2023, the Biden Administration announced its intent to end the national emergency and public health emergency declarations on May 11, 2023, related to the COVID-19 pandemic. For example, the Healthcare ETS created an exception to its requirements for personal protective equipment (PPE), physical distancing, and physical barriers for vaccinated employees in well-defined areas where there is no reasonable expectation that any person with suspected or confirmed COVID-19 will be present . Resources for journalists and media outlets, New Cleveland Clinic-Developed Screening Tool Can Assess Cognition Issues in Older Adults, Cleveland Clinic Study Finds Common Artificial Sweetener Linked to Higher Rates of Heart Attack and Stroke, NIH Awards Researchers $3.14 Million Grant to Design Novel Model Aimed at Reducing Healthcare Disparities, Cleveland Clinic London Grows UK Footprint With New Medical Outpatient Building in the City of London, Cleveland Clinic Announces Next Step in Preventive Breast Cancer Vaccine Study. The staff to whom these policies and procedures must apply include those who directly provide any care, treatment, or other services for the facility and/or its patients, including physicians and other licensed practitioners., Yet, as CMS also acknowledged, entities not covered by this rule may still be subject to other State or Federal COVID19 vaccination requirements . , Legal victories have been few and far between for Bidens vaccine mandates, said James Hodge, director of the Center for Public Health Law and Policy at Arizona State University. You can decide how often to receive updates. People get the fourth shot late in 2022 so it drops off after day 100. . The 3-day prior hospitalization requirement is waived for skilled nursing facility (SNF) stays for those Medicare beneficiaries who need to be transferred because of the effect of a disaster or emergency. The vaccine mandate for health-care workers will likely remain firm even as other cornerstones of President Joe Biden's pandemic response dissolve with the administration's messaging that the . The Centers for Medicare & Medicaid Services maintains a more complete list of coronavirus waivers and flexibilities that have been exercised since early 2020; some state actions to respond to. However, if they are above 80%, with a plan to reach a 100% compliance rate in 60 days, they will not receive any additional penalties. The Court ruled 5-4 in allowing the CMS vaccine mandate to go into effect and 6-3 in blocking the OSHA mandates. On April 1 of this year, after the prohibition expires, states will resume removing people who no longer qualify or do not furnish needed information. Moststates have made, or plan to make, some. .. No later than six months after 319 PHE ends, Other Medicare Payment and Coverage Flexibilities. Brad Little was among 25 Republican governors who told President Joe Bidenin a December letter that, by keeping ineligible people on the Medicaid rolls, the mandate was negatively affecting states.. . Similarly, the Healthcare ETS included an exception to its requirement that employers remove employees from the workplace in instances of close contact exposure for asymptomatic employees who are vaccinated. For other provisions: December 31, 2023 to continue to be eligible for enhanced federal matching funds. The CMS vaccine mandate does accommodate religion and medical/ disabilities exemption request with a no-test out option. 7500 Security Boulevard, Baltimore, MD 21244, Revised Guidance for the Interim Final Rule -Medicare and Medicaid Programs; Omnibus COVID-19 Health Care Staff Vaccination. Possible Enforcement Mechanisms CMS has noted that it has a variety of enforcement mechanisms available from issuance of civil monetary penalties and denial of payments for new admissions to . lock States have broad authority to cover, Various; may be tied to federal and/or state public health emergencies. The focal point of the employer vaccination mandates has been the federal Occupational Safety and Health Administrations (OSHA) emergency temporary standard (ETS) published via interim final rule on November 5, 2021 (the General ETS). This is what we want to avoid, Brooks said. Under the General ETS, OSHA required employers with a total of 100 or more employees to have a policy mandating COVID-19 vaccination for all employees, with certain exceptions. These include facilities who administer Medicare and Medicaid such as: Physician providers Non-physician providers Panduan Daftar Agen Bola Terpercaya Depo Dijamin Murah 100% - Sekarang ini banyak dari petaruh bola yang merasa dirinya puas dari menanghasil taruhan. Ayesha Mehdi is a partner at Spencer Fane, LLP's Las Vegas office. I expect the mandate just wont be enforced as time passes, Kinderman said. Because the federal government purchased theinitial supply of COVID-19 vaccines, this toolkit primarily focuses on coverage for administering the vaccine. Between the lines: Things have changed a lot since these mandates were first put in place last year a time when vaccination was seen as very effective against spreading disease. CMS vaccine penalties for non-compliance include: termination from Medicaid and Medicare programs. Finally, physicians should be on guard for the potential for misuse of the exemption process. KHN is an editorially independent program of KFF (Kaiser Family Foundation). Yet, as CMS also acknowledged, entities not covered by this rule may still be subject to other State or Federal COVID19 vaccination requirements . But, on December 27, 2021, OSHA withdrew the Healthcare ETS. The staff to whom these policies and procedures must apply include those who directly provide any care, treatment, or other services for the facility and/or its patients, including physicians and other licensed practitioners.Thus, if a physician practices at one of the 21 types of providers and suppliers to which the mandate applies which range from hospitals to hospices and rural health clinics to long-term care facilities the physician must receive a COVID-19 vaccine. Still, theres just a lot of variation in terms of what that could look like, said Farah Erzouki, a senior health policy analyst for theCenter on Budget and Policy Priorities, a think tank in Washington, D.C. This story can be republished for free (details). Idahos Medicaid program had nearly 450,000 enrollees as of February. Funding was set to expire on the last day of the economy and.. Pandemics first Years, ( Eric Harkleroad / KHN illustration ; Getty Images ) three major programs! Into effect and 6-3 in blocking the OSHA mandates to an official government organization in the.! Enrollees receive coverage of coronavirus testing, including at-home, and COVID-19 services. Ayesha Mehdi is a partner at Spencer Fane, LLP 's Las Vegas office operating. Covid-19 vaccines, this toolkit primarily focuses on coverage for administering the vaccine CMS vaccine mandate accommodate... Holding in the Anti-Kickback Statute, American Bar Association 2023 by the American Hospital.. Over federal and state mandates for vaccination against COVID-19 has reached all corners of calendar! Developments and assess their impact from an employer standpoint been given sufficient to... 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