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Why NAD+ declines with age Natural age-related decline : Decreased production Increased consumption (more cellular stress) Reduced recycling efficiency Mitochondrial dysfunction By age 50 : NAD+ levels about half of age 20 levels Impact : Everything from energy to recovery to longevity affected NAD+ boosting strategies Oral supplements (NMN, NR): Precursors that convert to NAD+ Variable absorption (5-30%) Modest NAD+ increase Affordable ($30-60/month) NAD+ IV therapy : Direct NAD+ infusion Immediate high levels Very expensive ($300-800 per session) Requires clinic visits NAD+ peptides : Stimulate natural NAD+ production Excellent bioavailability Sustained elevation Cost-effective ($50-150/month) Self-administered Best results : NAD+ peptides offer superior bioavailability and sustained effects vs oral supplements, at fraction of IV cost

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Changes to the REHQR Program Measure Set In the CY 2026 OPPS/ASC proposed rule (90 FR 33768 through 337722), we proposed to adopt the Emergency Care Access & Timeliness electronic clinical quality measure (eCQM) beginning with the CY 2027 reporting period/CY 2029 program determination as an alternative to reporting the Median Time from Emergency Department (ED) Arrival to ED Departure for Discharged ED Patients measure