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	"OMA Year (1First, Second, Third)"	County Code
010022	01	12060		Y		0.0038	CHEROKEE	Second	01090
010101	01	13820		Y		0.0321	TALLADEGA	Second	01600
010164	01	11500	LUGAR			0.0321	TALLADEGA	Second	01600
040076	04	26300	LUGAR			0.0561	HOT SPRING	Second	04290
070004	07		Accepted OMA			0.0677	LITCHFIELD	Third	07020
070011	07		Accepted OMA			0.0677	LITCHFIELD	Third	07020
070015	07	14860		Y		0.0677	LITCHFIELD	Third	07020
070026	07	35300	LUGAR			0.0677	LITCHFIELD	Third	07020
100139	10	23540	LUGAR			0.0011	LEVY	Second	10370
100322	10	23540	LUGAR			0.0011	LEVY	Second	10370
110040	11	12060	LUGAR			0.087	JACKSON	Second	11610
110187	11	12060	LUGAR			0.1002	LUMPKIN	First	11701
140167	14		Accepted OMA			0.0378	IROQUOIS	Second	14460
140236	14	28100	LUGAR			0.0378	IROQUOIS	Second	14460
150030	15	26900	LUGAR			0.0857	HENRY	Second	15320
150076	15	43780	LUGAR			0.0513	MARSHALL	Second	15490
150102	15	23844	LUGAR			0.0497	STARKE	Second	15740
150180	15	43780	LUGAR			0.0513	MARSHALL	Second	15490
160032	16	19780	LUGAR			0.0429	JASPER	First	16490
180025	18	31140	LUGAR			0.0386	NELSON	First	18890
190017	19	12940		Y		0.0173	ST. LANDRY	Second	19480
190033	19	29340	LUGAR			0.0104	JEFFRSON DAVIS	Second	19260
190053	19	29340	LUGAR			0.0104	JEFFRSON DAVIS	Second	19260
190078	19	29180	LUGAR			0.0173	ST. LANDRY	Second	19480
190191	19	29180	LUGAR			0.0173	ST. LANDRY	Second	19480
230005	23	11460	LUGAR			0.0138	LENAWEE	Second	23450
230113	23	11460	LUGAR			0.0138	LENAWEE	Second	23450
230121	23	29620	LUGAR			0.1104	SHIAWASSEE	Second	23770
230175	23	11460	LUGAR			0.0138	LENAWEE	Second	23450
230278	23	11460	LUGAR			0.0138	LENAWEE	Second	23450
240018	24	33460	LUGAR			0.0238	GOODHUE	Second	24240
240071	24	40340		Y		0.071	RICE	Second	24650
250117	25		Accepted OMA			0.032	PEARL RIVER	Second	25540
330175	33	27060	LUGAR		Y	0.0196	CORTLAND	Second	33210
330235	33	45060	LUGAR		Y	0.0272	CAYUGA	Second	33050
340071	34	39580	LUGAR			0.0336	HARNETT	Second	34420
340126	34	24780		Y		0.0341	WILSON	Second	34970
340127	34	20500	LUGAR			0.0808	GRANVILLE	Third	34380
340136	34	20500	LUGAR			0.0808	GRANVILLE	Third	34380
360096	36	49660	LUGAR			0.0058	COLUMBIANA	Second	36140
360125	36	17460	LUGAR		Y	0.026	ASHTABULA	Second	36030
360185	36	49660	LUGAR			0.0058	COLUMBIANA	Second	36140
360238	36	49660	LUGAR			0.0058	COLUMBIANA	Second	36140
360245	36	17460	LUGAR			0.026	ASHTABULA	Second	36030
390008	39		Accepted OMA			0.0119	LAWRENCE	Second	39450
390016	39	38300	LUGAR			0.0119	LAWRENCE	Second	39450
390030	39	25420		Y		0.037	SCHUYLKILL	Third	39650
390031	39		Accepted OMA			0.037	SCHUYLKILL	Third	39650
390071	39	44300		Y		0.0353	CLINTON	First	39240
390150	39		Accepted OMA			0.0084	GREENE	Second	39370
390183	39	10900		Y	Y	0.037	SCHUYLKILL	Third	39650
390313	39	39740	LUGAR			0.037	SCHUYLKILL	Third	39650
420030	42	16700	LUGAR		Y	0.012	COLLETON	Second	42140
420053	42	17900	LUGAR		Y	0.0049	NEWBERRY	Second	42350
450032	45	30980	LUGAR			0.0164	HARRISON	Second	45620
450192	45	23104	LUGAR			0.0415	HILL	Second	45651
450270	45	23104	LUGAR			0.0415	HILL	Second	45651
450283	45	19124	LUGAR			0.0562	VAN ZANDT	Second	45947
450389	45	46340	LUGAR			0.0376	HENDERSON	Second	45640
450770	45	12420	LUGAR			0.0445	MILAM	Second	45795
520071	52	33340	LUGAR			0.0445	JEFFERSON	Second	52270
520102	52		Accepted OMA			0.0296	WALWORTH	Second	52630
670094	45	12420	LUGAR			0.0445	MILAM	Second	45795
