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The guidance also says it does not intend to renew a funding mechanism for state health programs specific to Tennessees waiver called designated state investment programs or DSIP, approved by the Trump administration in 2021 and renegotiated by the Biden administration in 2023

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Cyanocobalamin is indicated for vitamin B 12 deficiencies due to malabsorption which may be associated with the following conditions: It may be possible to treat the underlying disease by surgical correction of anatomic lesions leading to small bowel bacterial overgrowth, expulsion of fish tapeworm, discontinuation of drugs leading to vitamin malabsorption (see Drug Interactions), use of a gluten-free diet in nontropical sprue, or administration of antibiotics in tropical sprue