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We explained our belief that if an ACO fails to meet both standards, it would be appropriate for CMS to take one of the actions described at 425.216 (provide a warning notice to the ACO, request a corrective action plan from the ACO, or place the ACO on a special monitoring plan) for noncompliance with the quality performance standards

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Dispose of the syringe in a designated sharps container immediately

Pre-medication with a bronchodilator may be recommended in such cases.

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