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(ix) If the quality measure is a patient-reported outcome

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In cases where improper payments originated inside the ACO: As a means to address our program integrity concerns, we would reopen the payment determination for any performance year of the ACO's subsequent agreement period issued prior to the revised initial determination for the performance year corresponding to the benchmark year impacted by improper payments originating inside the ACO, if the improper payments are anticipated to result in significant adjustment to the ACO's initial determination upon recalculation

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Its a great product though even if I may like a stronger mollasses taste which I didnt find the golden blend really has a noticeable amount