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Gastroenterology 158:368388

But meat, dairy, cheese, and other animal products become problematic when they make up the bulk of a diet, especially if theyre heavily processed or contain high levels of saturated fats

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We note that, for cases in which a recommendation by the HOP Panel appears to result in or allow a violation of the 2 times rule, we generally accept the HOP Panel's recommendation because those recommendations are based on explicit consideration of resource use, clinical homogeneity, site of service, and the quality of the claims data used to determine the APC payment rates