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We are finalizing that if CMS determines the ACO meets the requirements of § 425.512(c)(1), then, in alignment with § 425.512(c)(2)(ii) (as amended by this final rule), the ACO's minimum quality score will be set to the equivalent of the 40th percentile MIPS quality performance category score, excluding entities/providers eligible for facility-based scoring, for the relevant performance year

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Skin Type and Fitzpatrick Context South Florida patients are heavily Fitzpatrick III through V