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Some commenters suggested that CMS use an alternative term to refer to these technologies, such as Software as a Medical Device in conformance with FDA definitions, or clinical decision support tools. Some commenters provided suggestions on how CMS should categorize these types of services in terms of payment

Sickle Cell Anemia Pernicious Anemia Pernicious anemia, once it manifests, will require treatment for the duration of ones life, yet treatment is well tolerated and the disorder should not cause significant hardship

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Although generally safe, injections should be used with caution in people with a history of allergic reactions to cobalamin or in people with Leber's disease (hereditary optic neuropathy), as B12 may worsen the condition