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For example, participants in primary care models have indicated difficulty investing in and maintaining primary care redesign activities due to a range of challenges

There are no exceptions to the federal law

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If the manufacturer makes a timely request that includes all the supporting documentation, and CMS determines, based on its review of the reduction request and supporting documentation, that a reduction should be granted, CMS would reduce the total rebate amount owed by a manufacturer by 75 percent for the manufacturer's generic Part D rebatable drug for the applicable period in which the request was submitted or the following applicable period, depending on the timing of the submission of the request