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With regards to options for regulatory relief, we note that section 1895(b)(3)(D)(i) of the Act requires CMS to annually determine the impact of differences between the assumed behavior changes finalized in the CY 2019 HH PPS final rule with comment period (83 FR 56455) and actual behavior changes on estimated aggregate expenditures under the HH PPS with respect to years beginning with 2020 and ending with 2026

However, structured cycling with breaks is recommended to maintain receptor sensitivity

Some medications, such as antidepressants and pain relievers, can also contribute to feelings of fatigue

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