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( describes how Massachusetts requires plans to inventory enrollees' LTSS needs.) Although SNP Model of Care criteria do broadly allow DSNPs to insert state Medicaid-specific elements, the states and plans interviewed for this project reported that some CMS auditors, at least in early auditing cycles, have questioned the appropriateness of including such elements in the Model of Care

140 ERAD also modulates hepatic endocrine signaling by controlling the transcription of FGF21, a hormone that enhances energy expenditure and insulin sensitivity

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