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For example, if CMS grants a likely to be in shortage rebate reduction request for a generic Part D rebatable drug that was submitted on August 15, 2024, and that generic Part D rebatable drug is currently in shortage from September 15, 2025, until May 15, 2026, CMS would apply a 75 percent reduction in the total rebate amount for the duration of the applicable period for which the likely to be in shortage rebate reduction request was granted (that is, October 1, 2024, to September 30, 2025), and then would apply the shortages reduction as proposed in 428.301, beginning with a reduction of 75 percent for a generic Part D rebatable drug for the applicable period beginning October 1, 2025

(ii) For a Part D rebatable drug that is not a generic drug or plasma-derived product: (A) 25 percent for the first applicable period such drug is currently in shortage

(C) Participation in a certified or recognized patient-centered medical home (PCMH) or comparable specialty practice, as described at 414.1380(b)(3)(ii)

1395jjj.) Section 1899 of the Act has been amended through subsequent legislation