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(2) Allow Modifications to the SNF Affiliate List for SNF Affiliate CHOWs During a Performance Year As we described in the CY 2026 PFS proposed rule (90 FR 32663), ACOs have requested that we establish a mechanism to report a CHOW which results in a change in the Medicare-enrolled TIN for an approved SNF affiliate, which can be reviewed and effectuated by CMS during the performance year

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