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Dockstader said the tobacco he was told to pay duty for "was not our sacred Oyu:kwa [green tobacco], but commercial tobacco is still used in ceremony, and even if it's for smoking, it's still a traditional item." He said he won't pay the fine and is fighting to get the tobacco back

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[474] A recent study noted the resource intensity of quality reporting, underscoring the high cost of claims-based measures relative to others and recommended that policy makers shift to electronic metrics to optimize resources spent in the overall pursuit of higher quality. [475] For these reasons, and to continue encouraging ACOs on their progress to adopt digital quality measurement, we are not modifying the availability of eCQMs as a collection type for ACOs that reported the APP quality measure set by including eCQMs as a collection type in the APP Plus quality measure set in performance year 2025 and subsequent performance years