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In addition to maintaining the stability of cytoplasmic proteins, they can also act on the build-up of HIF-1 and the stimulation of its transcription

When the status of a Part B rebatable drug changes from currently in shortage to resolved during a calendar quarter and then changes to currently in shortage during one or more of the subsequent 3 calendar quarters, we stated in the CY 2025 PFS proposed rule (89 FR 61952) that CMS would apply the shortage reduction as if there was a continuous shortage beginning with the quarter in which the drug has re-entered a shortage and move to the percent reduction applicable for the second 4 consecutive quarters

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We discussed that we considered an alternative where we would permit prescribers to apply for a waiver for circumstances beyond their control rather than modify the date to include prescriptions for beneficiaries in LTC in the compliance threshold calculation