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Gopal Grandhige, MD, FACS, Board-Certified Surgeon Last Reviewed: April 5, 2026 Smoking significantly worsens acid reflux and GERD by weakening the lower esophageal sphincter (LES), increasing stomach acid production, and impairing the esophaguss ability to clear acid

median = 11 years, standard deviation = 6.9 years)

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For example, if the specified amount is very low due to negative ASP data and the payment amount is updated using other available data resulting in a payment amount that exceeds the inflation-adjusted payment amount, beneficiaries would not receive the benefit of adjusted coinsurance