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Mechanistically, GHK-Cu has been shown to stimulate collagen and elastin synthesis in dermal fibroblasts, increase decorin (a small proteoglycan that helps regulate collagen organization), and influence matrix metalloproteinases and their inhibitors

CMS attempted to phase out expenditure authority for DSHP in Section 1115 Demonstrations in 2017 and in 2022, limited the size and scope of DSHP with required state contributions, a cap on the total amount of federal and state DSHP expenditure authority, and time limits for federal funds