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As discussed in the FY 2020 IPPS/LTCH PPS proposed rule (84 FR 19592), we stated that rather than trying to predict which claims and/or hospitals may be subject to outlier reconciliation, we believe a methodology that incorporates an estimate of outlier reconciliation dollars based on actual outlier reconciliation amounts reported in historical cost reports would be a more feasible approach and provide a better estimate and predictor of outlier reconciliation for the upcoming fiscal year

In the MET4-IO clinical trial, MET4 combined with ICIs demonstrated safety in advanced solid tumors and showed signs of efficacyincluding stable disease in 40% of patientsby reprogramming bile acid metabolism (elevating tauroursodeoxycholic acid) and enhancing CD8 + T cell infiltration (267)

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However, after long-term intake of a dosage of 1 gram or more, symptoms such as nausea, vomiting, and diarrhea have been observed, and in extremely rare cases, liver damage may also occur (77)