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Clinical trials that test medications for safety and effectiveness often exclude pregnant individuals due to ethical concerns

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CAR received a daily supplement of 125 g per cow of a rumen-protected L-carnitine product (Carneon 20 Rumin-Pro, Kaesler Nutrition GmbH, Cuxhaven, Germany) with the concentrate feed, resulting in 25 g of L-carnitine per cow and day, while CON received a supplement to equalize the fat content (BergaFat F-100 HP, Berg + Schmidt GmbH & Co

CMS also has the authority to issue guidance on coverage criteria through National Coverage Determinations (NCDs)

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