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In recent years, in addition to its pyruvate kinase function, PKM2 has sparked considerable interest for its noncanonical function, which regulates gene expression as a transcription factor coactivator of Hif-1, -catenin, and p53 30,31,32 or phosphorylates proteins as a protein kinase 33,34,35,36

We will continue to consider ways to minimize program disruptions for ACOs that could result from one or more reopenings, to the extent feasible, and to reduce operational burdens for both ACOs and CMS that could result from making payment adjustments, as reflected in the discussion in the CY 2025 PFS proposed rule (89 FR 61896 through 61897), and earlier rulemaking (see for example, 81 FR 38001 through 38002

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However, if any side effects persist or worsen, consulting a doctor is advisable