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The rationale for combining or "stacking" ipamorelin and CJC-1295 is that they engage two distinct receptors that both feed into GH release

Loss of deubiquitylase USP2 triggers development of glioblastoma via TGF- signaling

Geneva: World Health Organization (2019)

Because MDHs are paid based on the IPPS Federal rate, they continue to be eligible to receive empirically justified Medicare DSH payments and uncompensated care payments if their DPP is at least 15 percent, and we apply the same process to determine MDHs' eligibility for interim empirically justified Medicare DSH and interim uncompensated care payments as we do for all other IPPS hospitals