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Additional information Peer review information Nature Metabolism thanks Dominique Langin and the other, anonymous reviewers for their contribution to the peer review of this work

(A) Proposal To Modify Scoring for the ONC Direct Review and ONC-ACB Surveillance Attestations The proposal to remove the ONC Direct Review and ONC-ACB Surveillance attestations beginning with the CY 2026 performance period/2028 MIPS payment year as discussed in section IV.A.4.d.(4)(c)(ii) of this proposed rule will be reflected in the scoring of the MIPS Promoting Interoperability performance category in the following manner

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A: The injection has a shelf life of 24 months from manufacturing, but once opened, it should be used immediately to avoid contamination and ensure efficacy