Lugar Hospitals in Counties that Qualify for an Outmigration Adjustment  for FY 2018									
"Please note that hospitals cannot receive the out-migration adjustment if they are reclassified under under section 1886(d)(8)(B) [Lugar/NECMA], 1886(d)(10) [MGCRB], or 1886(d)(8)(E) [Rural Reclassification] of the Act.  We will automatically assume that hospitals that are reclassified wish to retain their reclassification/redesignation status, and waive the application of the out-migration adjustment.  Section 1886(d)(10) hospitals that wish to receive the out-migration adjustment, rather than their reclassification,  must follow the termination/withdrawal procedures specified in 42 CFR 412.273 and section III.I.3. of the preamble of the FY 2012 final rule (76 FR 51601 through 51602). Hospitals redesignated under section 1886(d)(8)(B) of the Act are deemed to have waived the out-migration adjustment, unless they explicitly notified CMS that they elected to receive the out?migration adjustment  within 45 days from the  publication of the proposed rule. Hospitals redesignated under section under section 1886(d)(8)(B) of the Act are also eligible to be reclassified to a different area by the MGCRB. Using Table 3 associated with the proposed rule (which is available via the Internet on the CMS Web site), affected hospitals may compare the reclassified wage index for the labor market area into which they would be reclassified to under section 1886(d)(8)(B) of the Act. Hospitals may withdraw from an MGCRB reclassification within 45 days of the publication of the proposed rule."									
CCN	Geographic CBSA	Reclassified/Redesignated CBSA	Lugar/NECMA Reclass	MGCRB Reclass	Hospital Reclassified as Rural Under Section 1886(d)(8)(E) of the Act (412.103)	Out-Migration Adjustment (OMA)	County Name	County Code	"OMA Year (1First, Second, Third)"
010022	01	12060		Y		0.0038	CHEROKEE	01090	Second
010101	01	13820		Y		0.0321	TALLADEGA	01600	Second
010164	01		Accepted OMA			0.0321	TALLADEGA	01600	Second
040076	04	26300	LUGAR			0.0561	HOT SPRING	04290	Second
070004	07		Accepted OMA			0.0677	LITCHFIELD	07020	Third
070011	07		Accepted OMA			0.0677	LITCHFIELD	07020	Third
070015	07	14860		Y		0.0677	LITCHFIELD	07020	Third
070026	07	35300	LUGAR			0.0677	LITCHFIELD	07020	Third
100139	10	23540	LUGAR			0.0011	LEVY	10370	Second
100322	10	23540	LUGAR			0.0011	LEVY	10370	Second
110040	11	12060	LUGAR			0.087	JACKSON	11610	Second
110187	11	12060	LUGAR			0.1002	LUMPKIN	11701	First
140167	14		Accepted OMA			0.0378	IROQUOIS	14460	Second
140236	14	28100	LUGAR			0.0378	IROQUOIS	14460	Second
150030	15	26900	LUGAR			0.0857	HENRY	15320	Second
150076	15	43780	LUGAR			0.0513	MARSHALL	15490	Second
150102	15	23844	LUGAR			0.0497	STARKE	15740	Second
150180	15	43780	LUGAR			0.0513	MARSHALL	15490	Second
160032	16	19780	LUGAR			0.0429	JASPER	16490	First
180025	18	31140	LUGAR			0.0386	NELSON	18890	First
190017	19	12940		Y		0.0173	ST. LANDRY	19480	Second
190033	19	29340	LUGAR			0.0104	JEFFRSON DAVIS	19260	Second
190053	19	29340	LUGAR			0.0104	JEFFRSON DAVIS	19260	Second
190078	19	29180	LUGAR			0.0173	ST. LANDRY	19480	Second
190191	19	29180	LUGAR			0.0173	ST. LANDRY	19480	Second
230005	23	11460	LUGAR			0.0138	LENAWEE	23450	Second
230113	23	11460	LUGAR			0.0138	LENAWEE	23450	Second
230121	23	29620	LUGAR			0.1104	SHIAWASSEE	23770	Second
230175	23	11460	LUGAR			0.0138	LENAWEE	23450	Second
230278	23	11460	LUGAR			0.0138	LENAWEE	23450	Second
240018	24	33460	LUGAR			0.0238	GOODHUE	24240	Second
240071	24	40340		Y		0.071	RICE	24650	Second
250117	25		Accepted OMA			0.032	PEARL RIVER	25540	Second
330175	33	27060	LUGAR		Y	0.0196	CORTLAND	33210	Second
330235	33	45060	LUGAR		Y	0.0272	CAYUGA	33050	Second
340071	34	39580	LUGAR			0.0336	HARNETT	34420	Second
340126	34	39580		Y		0.0341	WILSON	34970	Second
340127	34	20500	LUGAR			0.0808	GRANVILLE	34380	Third
340136	34	20500	LUGAR			0.0808	GRANVILLE	34380	Third
360096	36	49660	LUGAR			0.0058	COLUMBIANA	36140	Second
360125	36	17460	LUGAR		Y	0.026	ASHTABULA	36030	Second
360185	36	49660	LUGAR			0.0058	COLUMBIANA	36140	Second
360238	36	49660	LUGAR			0.0058	COLUMBIANA	36140	Second
360245	36	17460	LUGAR			0.026	ASHTABULA	36030	Second
390008	39		Accepted OMA			0.0119	LAWRENCE	39450	Second
390016	39	38300	LUGAR			0.0119	LAWRENCE	39450	Second
390030	39	25420		Y		0.037	SCHUYLKILL	39650	Third
390031	39		Accepted OMA			0.037	SCHUYLKILL	39650	Third
390071	39	44300		Y		0.0353	CLINTON	39240	First
390150	39		Accepted OMA			0.0084	GREENE	39370	Second
390183	39	39740	LUGAR		Y	0.037	SCHUYLKILL	39650	Third
390313	39	39740	LUGAR			0.037	SCHUYLKILL	39650	Third
420030	42	16700	LUGAR		Y	0.012	COLLETON	42140	Second
420053	42	17900	LUGAR		Y	0.0049	NEWBERRY	42350	Second
450032	45	30980	LUGAR			0.0164	HARRISON	45620	Second
450192	45	23104	LUGAR			0.0415	HILL	45651	Second
450270	45	23104	LUGAR			0.0415	HILL	45651	Second
450283	45	19124	LUGAR			0.0562	VAN ZANDT	45947	Second
450389	45	46340	LUGAR			0.0376	HENDERSON	45640	Second
450770	45	12420	LUGAR			0.0445	MILAM	45795	Second
520071	52	33340	LUGAR			0.0445	JEFFERSON	52270	Second
520102	52		Accepted OMA			0.0296	WALWORTH	52630	Second
520116	52	33340	LUGAR			0.0445	JEFFERSON	52270	Second
670094	45	12420	LUGAR			0.0445	MILAM	45795	Second
