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Response: We acknowledge the commenter's recommendation for earlier removal of the measure but note that the proposed adoption of the Emergency Care Access & Timeliness eCQM begins with voluntary reporting for the CY 2027 reporting period, followed by mandatory reporting beginning with the CY 2028 reporting period/CY 2030 payment determination

Yes - GHK-Cu is particularly relevant for skin in perimenopause and menopause

Other malabsorption causes include: Atrophic gastritis and reduced gastric acid production (common in older adults) Gastrointestinal surgery, particularly gastrectomy, ileal resection, or bariatric surgery (especially gastric bypass) Inflammatory bowel disease affecting the terminal ileum (Crohn's disease) Coeliac disease and other small bowel disorders Chronic pancreatitis affecting enzyme secretion Helicobacter pylori infection (may contribute to reduced absorption) Medication-related deficiency is increasingly recognised

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Allergic Responses: Rare rashes, possibly from GHK-Cu or KPV in sensitives