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Differences in individual anatomy and nerve innervation: There is controversy over the colon innervation range of the human vagus nerve, and there are individual differences in the distribution of the auricular vagus nerve and the baseline level of vagus nerve activity, resulting in different intensities of the effect of VNS on the gut and the activation of pathways

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“After reviewing these approvals, CMS has determined these programs were funded entirely without federal Medicaid funds prior to those approvals, and the addition of federal Medicaid funding does not render these programs as integral components of section 1115 demonstration programs,” the agency said in a letter (PDF) to states