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We subsequently revised 425.315 to apply the policies on reopening determinations to payment determinations for a 6-month performance year or 6-month performance period during CY 2019 (refer to the November 2018 final rule, 83 FR 59958 and 60092, and the December 2018 final rule, 83 FR 67955 through 67967), and to ACOs participating in the BASIC track (refer to the December 2018 final rule, 83 FR 67842 and 68068)

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In our study, the ACTH levels might have possibly increased more gradually after the activation of the HPA-axis in response to the psychological stressor, and this might have resulted in a delayed feedback and therefore a longer cortisol response compared to physiological validation studies