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 . This two-phase plan includes criteria for: definitions and thresholds for non-compliance. These requirements could include COVID-19 mitigation measures enforced by state OSHA agencies in those states that have their own occupational safety and health plans approved by federal OSHA. Follow @meredith_freed on Twitter And third, they may be subject to COVID-19 vaccination mandates as gatekeepers for other individuals seeking a physicians certification for a vaccination exemption. First and most fundamentally physicians must be competent to understand the clinical factors that indicate risk for a complication resulting from COVID-19 vaccination, and the likelihood of such risk based on an individuals state of health. It's time to renew your membership and keep access to free CLE, valuable publications and more. 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. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). Employers subject to the Healthcare ETS were expressly exempt from the General ETS that the Court stayed in, Had the Healthcare ETS continued in effect, it would have impacted many physician practices, given that it applied broadly to all settings where any employee provided healthcare services or healthcare support services.. 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. 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 . On January 13, 2022, in a 5-4 split decision, the Court issued an opinion staying the injunctions against the healthcare interim final rule, which allows the Centers for Medicare & Medicaid Services (CMS) to now enforce its vaccine mandate nationwide (with the key compliance dates now being January 27, 2022, and February 28, 2022). No later than six months after 319 PHE ends, Other Medicare Payment and Coverage Flexibilities. Share sensitive information only on official, secure websites. HHS issued, Health care providers about your signed agreements to administer COVID-19 vaccines to patients free-of-charge, Group health plans and health insurers that youre legally required to cover COVID-19 vaccines and diagnostic testing without patient cost sharing, Administer the vaccine with no out-of-pocket cost to your patients for the vaccine or administration of the vaccine, Vaccinate everyone, including the uninsured, regardless of coverage or network status, Providers who have questions about billing or reimbursement of vaccine administration for patients covered by private insurance or Medicaid should contact the respective health plan or, Providers administering the vaccine to people without health insurancewere able to request reimbursement for the administration of the COVID-19 vaccine through the, Providers administering the vaccine to underinsured individuals were able to request reimbursement for the administration of the COVID-19 vaccine through the, How you can enroll in Medicare to bill for administering COVID-19 vaccines, The COVID-19 vaccine Medicare coding structure, Medicare payment rates for administering COVID-19 vaccines, How tobillcorrectly for administering vaccines, including roster and centralized billing, Monoclonal antibody infusion for treating COVID-19, New COVID-19 Treatments Add-on Payment (NCTAP), Enrollment for Administering COVID-19 Vaccine Shots, Medicare Billing for COVID-19 Vaccine Shot Administration, SNF: Enforcement Discretion Relating to Certain Pharmacy Billing, Beneficiary Incentives for COVID-19 Vaccine Shots, CMS Quality Reporting for COVID-19 Vaccine Shots, New COVID-19 Treatments Add-On Payment (NCTAP), FDA limited the authorized use of the Janssen COVID-19 vaccine, Janssen COVID-19 vaccine (Johnson & Johnson), COVID-19 vaccine guidance for moderately or severely immunocompromised patients, Health Resources & Services Administration (HRSA)COVID-19 Uninsured Program, Patients 18 years and older for whom other authorized or approved COVID-19 vaccines are not accessible or clinically appropriate, Patients 18 years and older who elect to receive the Janssen COVID-19 vaccine because they would otherwise not receive a COVID-19 vaccine, Third primary series dose in certain immunocompromised patients 18 years and older, Single booster dose for patients 18 years and older, 2-dose primary series for patients 5 years and older, Third primary series dose in certain immunocompromised patients 5 years and older, Single booster dose for patients 12 years and older, Charge your patients for an office visit or other fee if COVID-19 vaccination is the only medical service given, Require additional medical or other services during the visit as a condition for getting a COVID-19 vaccination, They only have Medicare Part A but not Part B coverage (or supplemental coverage for Part B services, like vaccine administration), Their insurance doesnt include the COVID-19 vaccine administration fees as a covered benefit (like Medicare Part A only), Their health insurance covers the COVID-19 vaccine administration but with cost sharing. 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 . On August 19, 2022, the FDA amended the Novavax COVID-19 vaccine, AdjuvantedEUA to authorize the use for all patients 1217 years old. March 21, 2022, 2:35 AM. CMS is committed to ensuring America's healthcare facilities respond effectively in an evidence-based way to the Coronavirus Disease 2019 (COVID-19) Public Health Emergency (PHE). Medical exemptions have been a common feature in many of the federal and state COVID-19 vaccination mandates to date. These include facilities who administer Medicare and Medicaid such as: Physician providers Non-physician providers Implications for Coverage, Costs,, On Jan. 30, 2023, the Biden Administration announced, Coronavirus Aid, Relief, and Economic Security (CARES) Act, Coverage, costs, and payment for COVID-19 testing, treatments, and vaccines, Medicaid coverage and federal match rates, Other Medicare payment and coverage flexibilities, Other private insurance coverage flexibilities, Access to medical countermeasures (vaccines, tests, and treatments) through FDA emergency use authorization (EUA), Liability immunity to administer medical countermeasures, Commercialization of COVID-19 Vaccines, Treatments, and Tests: Implications for Access and Coverage, Consolidated Appropriations Act (CAA), 2023. It remains to be seen if any future healthcare-focused regulation from OSHA will take the same form as the Healthcare ETS. By July, the state Medicaid agency had reinstated benefits for 6,400 people the state couldnt get hold of. Well update this toolkit as new information becomes available. 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. Date: February 14, 2022 Medicaid Coverage and Federal Match Rates. Its important to note, not everything on khn.org is available for republishing. Federal law generally banned states from dropping people, and federal officials said Idaho acted improperly. Follow @jenkatesdc on Twitter Like the CMS Vaccination Mandate, state vaccination mandates may be limited to workers at certain healthcare facilities. For physicians reviewing COVID-19 vaccination medical exemption requests, the role as gatekeeper comes with various responsibilities. Meredith Freed In the states where the mandate is still in place, CMS is requiring all hospitals and other providers that participate in Medicare and Medicaid to have their employees vaccinated with at least one dose of a Covid-19 vaccine by Jan. 27which will be 30 days after the guidance was releasedand two doses by Feb. 28, which will be the first . 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). While some workers have quit, and others might do the same because of CMS's mandate, there is substantial evidence that vaccine requirements significantly increase vaccination rates by at . Novel Coronavirus (SARS-CoV-2/COVID-19) Among the stakeholders, physicians are uniquely positioned. Physicians should continue to monitor these regulatory developments and assess their impact from an employer standpoint. 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. In some states, moreover, physicians may have to contend withanti-mandates that is, bans or restrictions on employers mandating that their employees receive a COVID-19 vaccine. KHN is an editorially independent program of KFF (Kaiser Family Foundation). The fourth shot increases your risk of death too. In one of the emails the Idaho Medicaid agency sent to CMS last July, the state said it was reviewing the extent to which it needed to pay medical bills the program had originally rejected. For example, states can modify or expand HCBS eligibility or services, modify or suspend service planning and delivery requirements, and adopt policies to support providers. CMS Vaccine Mandate. Share sensitive information only on official, secure websites. This pre-diluted vaccine is effective January 3, 2021. All states and D.C. temporarily waived some aspects of state licensure requirements, so that providers with equivalent licenses in other states could practice via telehealth. Now with the variants, that's less true, Wen says. 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. 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. Because the federal government purchased theinitial supply of COVID-19 vaccines, this toolkit primarily focuses on coverage for administering the vaccine. OSHA later withdrew the General ETS on January 26, 2022. 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 Employees who have not begun the vaccination process and do nothave an approved exemption or an exemption pending,have beenplacedon anunpaid leaveof absence (LOA)beginning today. https:// 11/18/21 Federal government files its response to states . This latter type of mandate potentially may apply to physician practices as businesses that employ personnel who must receive a COVID-19 vaccine. Memorandum Summary Effective 10-26-22, this memo has been superseded by QSO-23-02-ALL, Revised Guidance for Staff Vaccination Requirements. Idaho Dropped Thousands From Medicaid in the Pandemics First Years, (Eric Harkleroad / KHN illustration; Getty Images). CMS declined to answer several questions about the Idaho situation. Noncompliance includes any percentage less than 100%. If a story is labeled All Rights Reserved, we cannot grant permission to republish that item. But that is not the case for a lot of situations.. Your patients may know these as updated COVID-19 vaccines: Timeline of Previous COVID-19 Vaccine EUAs. Businesses opting for their own mandates can take steps to minimize claims and exposure. Meet Hemp-Derived Delta-9 THC. Share on Facebook. These obligations will depend on the applicable mandate for which an individual is seeking an exemption and may include specific documentation and record-keeping requirements. Besides, the current public health emergency wasnt a key element of the Supreme Courts reasoning when it allowed the vaccine mandate to resume. 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). 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). Heres how you know. it's easy: simply make the Medicare death-vaccination record-level data publicly . 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. A covid relief law Congress enacted in 2020 prohibited states from removing people from Medicaid except in a few narrow circumstances, such as if an enrollee died or moved out of state. 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.. Over two-thirds of those workers also reported receiving a COVID-19 booster dose. Secure .gov websites use HTTPSA 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. An official website of the United States government. This 100% group also includesthose with pending or granted requests for medical/religious exemptions and those identified as requiring temporary vaccination delays for medical reasons. The Court ruled 5-4 in allowing the CMS vaccine mandate to go into effect and 6-3 in blocking the OSHA mandates. 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. It shows how easily state bureaucracies can disenroll people they shouldnt be disenrolling, leaving those people in financial and medical jeopardy. Have questions? 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. You can support KHN by making a contribution to KFF, a non-profit charitable organization that is not associated with Kaiser Permanente. March 1, 2023. All rights reserved. Alternatively, OSHA permitted an employer to accept proof of regular COVID-19 testing from unvaccinated employees who would have to wear a face covering meeting specified requirements. On December 8, 2022, the FDA amended the emergency use authorizations (EUAs) of the updated (bivalent) Pfizer-BioNTech (PDF) and Moderna (PDF) COVID-19 vaccines to include use in children down to 6 months old. Learn more about a Bloomberg Law subscription. FDA grants full approval to Pfizer's COVID-19 vaccine for 12-15 age group. The agency is enforcing the requirement across the U.S., and deadlines for health-care workers to receive their first dose of a vaccine have already passed. The damage will be done, saidTricia Brooks, a research professor with Georgetown Universitys Center for Children and Families. But the federal government is not a particularly nimble entity. The CAA also phases down the enhanced federal funding through December 31, 2023. ( The CMS Covid-19 vaccine mandate is the first time the agency has imposed a federal vaccination mandatea significant step that highlights the unprecedented nature of the public health crisis, Shachar said. But if CMS had issued a written version of the standard to which it was holding Idaho in which disenrollments would be justified only if the state made contact with the enrollee Medicaid consumer advocates and other specialists said they were unaware of it. Tidak lain adalah karenag mereka tau cara taruhannya seperti apa hingga bisa daftar agen bola terpercaya. By Alex Maza | April 13, 2022 at 09:04 AM The results and long-term impact of lawsuits related to. Enforcement could change as the public health situation improves, said Karla Kinderman, a health-care attorney who used to work at the American Medical Association. A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. The Department of Health and Human Services has predicted that nearly 7 million people still entitled to Medicaid benefits will lose coverage because they fail to complete renewals or state governments wont be able to contact them. . All rights reserved. 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. Recent guidance by the Medical Board of California offers a cautionary reminder: [A] physician who grants a mask or other exemption without conducting an appropriate prior exam and without a finding of a legitimate medical reason supporting such an exemption within the standard of care may be subjecting their license to disciplinary action.. "At this point in the pandemic, the case for vaccine mandates is much weaker than it was in 2021," she adds. Some ends up at thewrong address. 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. Previously, these provisions were set to expire on the last day of the calendar quarter in which the 319 PHE ended. The justices decision was built around the unprecedented challenges of the public health situation, Rutschman said. 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. . While it was in effect, the Healthcare ETS didnotincludemandatoryvaccination on its list of COVID-19 mitigation measures. Thus, the Healthcare ETS was never a vaccination mandate per se. , lock End of 319 PHE, unless DEA specifies an earlier date. 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. 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 . The Supreme Court ruled in favor of the Medicare agencys mandate as the omicron variant ripped through the U.S. health-care system. 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. Oct. 19 Web Event: The Commercialization of COVID, The Coronavirus Aid, Relief, and Economic Security Act: Summary of Key Health Provisions, The Families First Coronavirus Response Act: Summary of Key Provisions, FAQs on Medicare Coverage and Costs Related to COVID-19 Testing and Treatment, Many Uninsured People Could Lose Access to Free COVID-19 Testing, Treatment, and Vaccines as Federal Funding Runs Out, Key Questions About the New Medicaid Eligibility Pathway for Uninsured Coronavirus Testing, Key Questions About the New Increase in Federal Medicaid Matching Funds for COVID-19, Medicare and Telehealth: Coverage and Use During the COVID-19 Pandemic and Options for the Future, Coverage, Costs, and Payment for COVID-19 Testing, Treatments, and Vaccines, Beneficiaries in traditional Medicare and Medicare Advantage pay, End of 319 PHE,except coverage and costs for oral antivirals, where changes were made in the. My perspective is, we did our due diligence, he added. Get important, CMS released this toolkit for providers, and a, Help the health care system quickly administer vaccines as they're available, Increase the number of providers who can administer the vaccine, Ensure adequate Medicare paymentfor administering the vaccine, Ensure private insurers and Medicaid programs understandtheir responsibility to cover the vaccine at no cost to patients, Health care providers play an important role and we're committed to ensuring you have the necessary tools to respond to the COVID-19 public health emergency (PHE). If any state isnt following the rules, Georgetown Universitys Brooks said, it can take months to fix the problems all while peoples benefits hang in the balance. Log in to access all of your BLAW products. Learn about COVID-19 vaccine guidance for moderately or severely immunocompromised patients. Thank you! Official websites use .govA Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in San Francisco, California. At the same time, such unprecedented circumstances provide no grounds for limiting the exercise of authorities the agency has long been recognized to have.. .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. CMS also published an FAQ covering the most important aspects of the rule. Heres how you know. The FDA amended EUAs to authorize the use of first booster doses, as follows: On August 23, 2021, the FDA approved the Pfizer-BioNTech COVID-19 vaccine, marketed as COMIRNATY, for the prevention of COVID-19 disease in patients 16 years and older. On July 13, 2022, the FDA authorized emergency use of the Novavax COVID-19 vaccine, Adjuvanted for the prevention of COVID-19 disease in patients 18 years and older. There are three things Americas hospitals have in common right now: sicker patients, a smaller workforce and higher labor and supply costs, writes AHA, The Senate Health, Education, Labor & Pensions Committee last week held a hearing aptly titled Examining Health Care Workforce Shortages: Where Do We Go, The AHA today urged the Federal Trade Commission to withdraw its proposed rule that would ban contractual terms that prohibit workers from pursuing certain, The nations largest retail, payer and tech disruptors once again invested billions of dollars in health care in 2022, continuing to build out their visions to, Completing the Moderna or Pfizer COVID-19 monovalent vaccine primary series protects children aged 3-5 and 3-4, respectively, against symptomatic SARS-CoV-2, In astatement submitted to the Senate Health, Education, Labor & Pensions Committee for a hearing today on the nations health care workforce shortages, CMS updates guidance on COVID-19 vaccine mandate for health care workers, Updates and Resources on Novel Coronavirus (COVID-19), Institute for Diversity and Health Equity, Rural Health and Critical Access Hospitals, National Uniform Billing Committee (NUBC), AHA Rural Health Care Leadership Conference, Individual Membership Organization Events, The Important Role Hospitals Have in Serving Their Communities, memorandum and provider-specific guidance, Supporting Todays Workforce as We Develop Solutions for the Future, AHA urges FTC to withdraw proposed rule that would ban noncompete clauses in employer agreements, The Buzz on health care disruption: What to watch for in 2023, Study: COVID-19 vaccine effectiveness may wane in younger children as well, Senate holds hearing to examine health care workforce shortages, solutions, American Organization for Nursing Leadership. 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. Your patients may know these as "updated COVID-19 vaccines": Pfizer-BioNTech: all patients 6 months - 4 years old. .. States have broad authority to cover, Various; may be tied to federal and/or state public health emergencies. The challenges posed by a global pandemic do not allow a federal agency to exercise power that Congress has not conferred upon it, the justices wrote in their majority opinion. The CMSs win in the Supreme Court was narrow: a 5-4 decision from a right-leaning court. As further evidence that the vaccine-or-test mandate falls within OSHA's purview, the dissent highlighted that, last year, Congress appropriated $100 million for OSHA "to carry out COVID-19. , Other Medicare Payment and Coverage Flexibilities seen if any future healthcare-focused cms vaccine mandate april 2022 from will... Guidance for Staff vaccination Requirements stakeholders, physicians are uniquely positioned / illustration! Less true, Wen says a COVID-19 vaccine Guidance for moderately or severely immunocompromised patients Services. The CAA also phases down the enhanced federal funding through December 31, 2023 any. Narrow: a 5-4 decision from a right-leaning Court mitigation measures answer several questions about the Idaho.! Twitter Like the CMS vaccination mandate, state vaccination mandates may be limited to at. Take the same form as the Healthcare ETS was never a vaccination per... 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Record-Level data publicly these obligations will depend on the enforcement of another COVID-19... Maza | April 13, 2022 claims and exposure follow @ jenkatesdc Twitter! Shows how easily state bureaucracies can disenroll people they shouldnt be disenrolling, leaving those people in financial and jeopardy..., a research professor with Georgetown Universitys Center for Children and Families COVID-19 employer regulation: OSHAs so-called ETS... Vaccine Guidance for Staff vaccination Requirements various responsibilities Like the CMS vaccine mandate to go effect. Osha later withdrew the General ETS on January 26, 2022 Medicaid Coverage and federal Match Rates website managed paid... Innfibdidnothave any effect on the last day of the three major operating programs KFF. Per se of another federal COVID-19 employer regulation: OSHAs so-called Healthcare ETS was never a vaccination mandate state... 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Purchased theinitial supply of COVID-19 mitigation measures can support KHN by making a contribution KFF... From OSHA will take the same form as the omicron variant ripped the! Of mandate potentially may apply to physician practices as businesses that employ personnel who receive!, a non-profit charitable organization that is not a particularly nimble entity answer several questions about the Idaho situation Rates. That & # x27 ; s less true, Wen says Eric Harkleroad / KHN ;... Workers at certain Healthcare facilities a COVID-19 vaccine for 12-15 age group U.S. Centers for Medicare & Medicaid Services,! Because the federal government purchased theinitial supply of COVID-19 vaccines: Timeline of Previous vaccine! The applicable mandate for which an individual is seeking an exemption and may specific... Seperti apa hingga bisa daftar agen bola terpercaya results and long-term impact of lawsuits related to businesses opting their! 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