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For items and services encoded in the MRF with a standard charge methodology of case rate, per diem, or a known fee schedule, we stated that we expect hospitals will be able to encode a payer-specific negotiated charge: dollar amount. We recognized that there may be situations where the payer-specific negotiated charge is a percentage of a fee schedule that is not available to the hospital

In particular, the SAVOR-TIMI 53 (Saxagliptin Assessment of Vascular Outcomes Recorded in Patients with Diabetes Mellitus) clinical trial evidenced neutral effects of saxagliptin in terms of cardiovascular outcomes, but an increased risk of hospitalization for HF, especially in patients with high levels of natriuretic peptides, previous HF, or chronic kidney disease [148]

The SSA will take the medical opinion of these doctors into account too

Neumann, J.-M