Lugar Hospitals in Counties that Qualify for an Outmigration Adjustment  for FY 2019									
"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	01019	Third
010101	01	13820		Y		0.0321	TALLADEGA	01121	Third
010164	01		Accepted OMA			0.0321	TALLADEGA	01121	Third
040076	04	26300	LUGAR			0.0561	HOT SPRING	05059	Third
100139	10	23540	LUGAR			0.0011	LEVY	12075	Third
100322	10	23540	LUGAR			0.0011	LEVY	12075	Third
110040	11	12060	LUGAR			0.087	JACKSON	13157	Third
110187	11	12060	LUGAR			0.1001	LUMPKIN	13187	Second
140167	14		Accepted OMA			0.0378	IROQUOIS	17075	Third
140236	14	28100	LUGAR			0.0378	IROQUOIS	17075	Third
150030	15	26900	LUGAR			0.0857	HENRY	18065	Third
150076	15	43780	LUGAR			0.0513	MARSHALL	18099	Third
150102	15	23844	LUGAR			0.0497	STARKE	18149	Third
150180	15	43780	LUGAR			0.0513	MARSHALL	18099	Third
160032	16	19780	LUGAR			0.0448	JASPER	19099	Second
180025	18	31140	LUGAR			0.0375	NELSON	21179	Second
190017	19	12940		Y		0.0173	ST. LANDRY	22097	Third
190033	19	29340	LUGAR			0.0104	JEFFRSON DAVIS	22053	Third
190053	19	29340	LUGAR			0.0104	JEFFRSON DAVIS	22053	Third
190078	19	29180	LUGAR			0.0173	ST. LANDRY	22097	Third
190191	19	29180	LUGAR			0.0173	ST. LANDRY	22097	Third
230005	23	11460	LUGAR			0.0138	LENAWEE	26091	Third
230113	23	11460	LUGAR			0.0138	LENAWEE	26091	Third
230121	23	29620	LUGAR			0.1104	SHIAWASSEE	26155	Third
230175	23	11460	LUGAR			0.0138	LENAWEE	26091	Third
230278	23	11460	LUGAR			0.0138	LENAWEE	26091	Third
240018	24	33460	LUGAR			0.0238	GOODHUE	27049	Third
240071	24	40340		Y		0.071	RICE	27131	Third
250117	25		Accepted OMA			0.032	PEARL RIVER	28109	Third
330175	33	27060	LUGAR		Y	0.0196	CORTLAND	36023	Third
330235	33	45060	LUGAR		Y	0.0272	CAYUGA	36011	Third
340071	34	39580	LUGAR			0.0336	HARNETT	37085	Third
340126	34	24780		Y		0.0341	WILSON	37195	Third
340127	34	20500	LUGAR			0.0944	GRANVILLE	37077	First
340136	34	20500	LUGAR			0.0944	GRANVILLE	37077	First
360096	36	49660	LUGAR			0.0058	COLUMBIANA	39029	Third
360125	36	17460	LUGAR		Y	0.026	ASHTABULA	39007	Third
360185	36	38300		Y		0.0058	COLUMBIANA	39029	Third
360238	36	49660	LUGAR			0.0058	COLUMBIANA	39029	Third
360245	36	17460	LUGAR			0.026	ASHTABULA	39007	Third
390008	39		Accepted OMA			0.0119	LAWRENCE	42073	Third
390016	39	38300	LUGAR			0.0119	LAWRENCE	42073	Third
390030	39	30140		Y		0.0502	SCHUYLKILL	42107	First
390031	39	39740	LUGAR			0.0502	SCHUYLKILL	42107	First
390071	39	44300		Y		0.0353	CLINTON	42035	Second
390150	39		Accepted OMA			0.0084	GREENE	42059	Third
390183	39	39740	LUGAR		Y	0.0502	SCHUYLKILL	42107	First
390313	39	39740	LUGAR			0.0502	SCHUYLKILL	42107	First
420030	42	16700	LUGAR		Y	0.012	COLLETON	45029	Third
420053	42	17900	LUGAR		Y	0.0049	NEWBERRY	45071	Third
450032	45	30980	LUGAR			0.0164	HARRISON	48203	Third
450192	45	23104	LUGAR			0.0415	HILL	48217	Third
450270	45	23104	LUGAR			0.0415	HILL	48217	Third
450283	45	19124	LUGAR			0.0562	VAN ZANDT	48467	Third
450389	45	46340	LUGAR			0.0376	HENDERSON	48213	Third
450770	45	12420	LUGAR			0.0445	MILAM	48331	Third
520071	52	33340	LUGAR			0.0445	JEFFERSON	55055	Third
520102	52	29404	Accepted OMA	Y		0.0296	WALWORTH	55127	Third
520116	52	33340	LUGAR		Y	0.0445	JEFFERSON	55055	Third
670094	45	12420	LUGAR			0.0445	MILAM	48331	Third
670117	45	19124	LUGAR			0.0562	VAN ZANDT	48467	Third
