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The examples CMS cites in its noticesuch as non-medical in-home services, internet access for rural healthcare providers, and workforce development initiativesoften represent state-led innovations designed to address local community needs efficiently, especially in rural and underserved areas where healthcare resources are already strained

Originally, the Schilling test was used for this purpose, but it is no longer used in view of the safety factors related to the use of radioactive B12 ( 57 Cocyanocobalamin) (Sobczynska-Malefora et al., 2021)