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These taxes must be broad and uniformly applied, and taxpayers must not be held harmless. This means that the provider tax must be applied to all providers within a provider classification, regardless of whether a provider accepts Medicaid or not, and the state cannot guarantee the taxpayer will receive their tax revenue back beyond the safe harbor threshold of 6 percent or less of net patient revenues from treating patients

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This, by itself, is probably enough to metabolize in the human body and be detectable in the small amounts Balabanova et al have discovered