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This decline is partly inevitable biology, but it's accelerated by obesity, chronic stress, poor sleep, alcohol, and metabolic disease

They should be administered by trained clinicians who screen properly first

549 Chronic pain and disability associated with DPN can lead to significant psychological distress

* * * * * (c) * * * (2) * * * (i) * * * (A) * * * ( 10 ) Beginning with the 2026 MIPS payment year, for the quality and improvement activities performance categories, CMS determines, based on documentation provided to the agency on or before November 1st of the year preceding the relevant MIPS payment year, that data for a MIPS eligible clinician are inaccessible or unable to be submitted due to circumstances outside of the control of the clinician because the MIPS eligible clinician delegated submission of the data to their third party intermediary, evidenced by a written agreement between the MIPS eligible clinician and third party intermediary, and the third party intermediary did not submit the data for the performance category(ies) on behalf of the MIPS eligible clinician in accordance with applicable deadlines