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Therefore, we are considering applying a combination of the following factors in determining whether to reopen an initial determination: (1) consideration of the timing of reopening and recalculating the payment determination for a performance year, and the timing of financial reconciliation for one or more performance year of a subsequent agreement period that includes the affected period as a benchmark year, and (2) consideration of whether the improper payments result from conduct of individuals or entities performing functions or services related to the ACO's activities

A number of studies have indicated a higher risk of alcohol misuse and dependence in the adopted-away sons of alcohol-dependent biological parents than in the adopted-away sons of non-alcohol-dependent biological parents