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A commenter recommended that CMS monitor ASC feedback during the voluntary reporting period to ensure ASCs do not face widespread technical or operational challenges which would require postponing mandatory implementation

In CD, its pro-inflammatory LPS suppresses the bile acid transporter ASBT via TLR4 and MAPKc-Jun/c-Fos signaling, impairing bile acid reabsorption and exacerbating Clostridioides difficile infection (Yang et al., 2025)