Lugar Hospitals in Counties that Qualify for an Outmigration Adjustment  for FY 2016									
"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)	"OMA Year (1First, Second, Third)"	County Name	County Code
010022	   01	12060		Y	 	0.1024	Third	CHEROKEE	01090
010101	   01	13820		Y	 	0.0196	Third	TALLADEGA	01600
010164	   01	11500	LUGAR	 	 	0.0196	Third	TALLADEGA	01600
040076	   04	26300	LUGAR	 	 	0.0672	Third	HOT SPRING	04290
070004	   07	   07		 	Y	0.0687	First	LITCHFIELD	07020
070011	   07	35300	LUGAR	 	 	0.0687	First	LITCHFIELD	07020
070015	   07	35614	LUGAR	 	 	0.0687	First	LITCHFIELD	07020
110040	   11	12060	LUGAR	 	 	0.1028	Third	JACKSON	11610
110187	   11	12060	LUGAR	 	 	0.0769	Third	LUMPKIN	11701
140167	   14	     	Accepted OMA	 	 	0.0434	Third	IROQUOIS	14460
150030	   15	26900	LUGAR	 	 	0.0357	Third	HENRY	15320
150076	   15	43780	LUGAR	 	 	0.0182	Third	MARSHALL	15490
150102	   15	23844	LUGAR	 	 	0.0166	Third	STARKE	15740
150180	   15	43780	LUGAR	 	 	0.0182	Third	MARSHALL	15490
160032	   16	19780	LUGAR	 	 	0.0347	Third	JASPER	16490
170014	   17	28140	LUGAR	 	 	0.0316	Second	FRANKLIN	17290
180025	   18	31140	LUGAR	 	 	0.0323	Second	NELSON	18890
190017	   19	29180		Y	 	0.01	Third	ST. LANDRY	19480
190053	   19	29340	LUGAR	 	 	0.0052	Third	JEFFRSON DAVIS	19260
230005	   23	11460	LUGAR	 	 	0.0572	Third	LENAWEE	23450
230121	   23	29620	LUGAR	 	 	0.1116	Third	SHIAWASSEE	23770
240018	   24	33460	LUGAR	 	 	0.1317	Third	GOODHUE	24240
240071	   24	33460	LUGAR	 	 	0.04	Third	RICE	24650
250117	   25	     	Accepted OMA	 	 	0.0624	Third	PEARL RIVER	25540
330047	   33	     	Accepted OMA	 	 	0.0076	Third	MONTGOMERY	33380
330073	   33	40380	LUGAR	 	 	0.0138	Third	GENESEE	33290
330175	   33	   33		 	Y	0.0239	Third	CORTLAND	33210
330235	   33	   33		 	Y	0.0296	Third	CAYUGA	33050
340071	   34	39580	LUGAR	 	 	0.0236	Third	HARNETT	34420
340126	   34	39580		Y	 	0.0125	Third	WILSON	34970
340127	   34	20500	LUGAR	 	 	0.0883	First	GRANVILLE	34380
360096	   36	49660	LUGAR	 	 	0.0025	Third	COLUMBIANA	36140
360125	   36	   36		 	Y	0.0158	Third	ASHTABULA	36030
360185	   36	15940		Y	 	0.0025	Third	COLUMBIANA	36140
360245	   36	17460	LUGAR	 	 	0.0158	Third	ASHTABULA	36030
390008	   39	     	Accepted OMA	 	 	0.0024	Third	LAWRENCE	39450
390016	   39	38300	LUGAR	 	 	0.0024	Third	LAWRENCE	39450
390030	   39	25420		Y	 	0.0332	First	SCHUYLKILL	39650
390031	   39	39740	LUGAR	 	 	0.0332	First	SCHUYLKILL	39650
390071	   39	48700	LUGAR	 	 	0.011	Second	CLINTON	39240
390150	   39	     	Accepted OMA	 	 	0.0022	Third	GREENE	39370
390183	   39	   39		 	Y	0.0332	First	SCHUYLKILL	39650
420030	   42	16700	LUGAR	 	 	0.0098	Third	COLLETON	42140
420053	   42	   42		 	Y	0.0094	Third	NEWBERRY	42350
450032	   45	30980	LUGAR	 	 	0.0337	Third	HARRISON	45620
450052	   45	   45		 	Y	0.0251	Third	BOSQUE	45160
450192	   45	23104	LUGAR	 	 	0.0255	Third	HILL	45651
450270	   45	23104	LUGAR	 	 	0.0255	Third	HILL	45651
450389	   45	46340	LUGAR	 	 	0.0559	Third	HENDERSON	45640
520071	   52	33340	Accepted OMA	 	 	0.0273	Third	JEFFERSON	52270
520102	   52	33340	LUGAR	 	 	0.0423	Third	WALWORTH	52630
520116	   52	33340	LUGAR	 	 	0.0273	Third	JEFFERSON	52270
670094	   45	12420	LUGAR	 	 	0.0217	Third	MILAM	45795
									
"1.   ""First"" OMA values are proposed figures, and are subject to change in the final rule."									
