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Fernandez then had to stop the injections several times because McClendon reported not being able to breathe and was in pain

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Respondents broadly identified three primary reasons for near payment equivalence: Statutory and regulatory provisions that limit out-of-network payments to traditional Medicare rates, De facto budget constraints that MA plans face because of the need to compete with traditional Medicare and other MA plans, and A market equilibrium that permits relatively lower MA rates as long as commercial rates remain well above the traditional Medicare rates