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Their mechanism of action involves blocking cholinergic receptors, thereby reducing the effect of acetylcholine in the nigrostriatal pathway to restore the balance between dopamine and cholinergic neurotransmitters, which underlies their therapeutic effect [131]

Accordingly, for FY 2022, section 1886(b)(3)(B)(ix) of the Act in conjunction with section 602(d) of Public Law 114-113 requires that any subsection (d) Puerto Rico hospital that is not a meaningful EHR user as defined in section 1886(n)(3) of the Act and not subject to an exception under section 1886(b)(3)(B)(ix) of the Act will have three-quarters of the applicable percentage increase (prior to the application of other statutory adjustments), or three-quarters of the applicable market basket rate-of-increase, reduced by 33 1/3 percent

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