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The proportion of patients that needed a change in epoprostenol dose (an indicator of clinical worsening) was 0.195 in the epoprostenol-only group with a lower proportion (0.062) in the combination group

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As we noted in the CY 2011 HH PPS final rule (75 FR 70397 through 70399), section 3131(b)(1) of the Affordable Care Act amended section 1895(b)(3)(C) of the Act to require that the Secretary reduce the HH PPS payment rates such that aggregate HH PPS payments were reduced by 5 percent