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After reviewing these approvals, CMS has determined these programs were funded entirely without federal Medicaid funds prior to those approvals, and the addition of federal Medicaid funding does not render these programs as integral components of section 1115 demonstration programs, the agency said in a letter (PDF) to states

Explored in central nervous-system signaling research

That distinction matters, and prescribers should be clear-eyed about it

it produces weight loss through caloric restriction, not metabolic reprogramming