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While these may be services that a practitioner using the advanced primary care model would be likely to furnish, when appropriate, they are not part of the core, routinely and universally essential elements of the advanced primary care model

You always have the right to refuse treatment

But that's just my sense of it

In accordance with our regulations governing third party intermediaries at 414.1400(a)(3)(iv) and (e)(1), we may take remedial action in the event a third party intermediary fails to meet the criteria necessary for their approval as a third party intermediary, fails to comply with other requirements applicable to third party intermediaries, has submitted a false certification, or discontinues their services and do not assist MIPS eligible clinicians in connecting with a different third party intermediary