Lugar Hospitals in Counties that Qualify for an Outmigration Adjustment  for FY 2020																						
"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		0.1024	CHEROKEE	01019	First													
010101	01	13820		Y		0.0464	TALLADEGA	01121	First													
010164	01	13820	LUGAR			0.0464	TALLADEGA	01121	First													
040076	04	26300	LUGAR			0.0528	HOT SPRING	05059	First													
070004	07		Accepted OMA			0.0017	LITCHFIELD	09005	Second													
070011	07		Accepted OMA			0.0017	LITCHFIELD	09005	Second													
070015	07	14860		Y		0.0017	LITCHFIELD	09005	Second													
07B033	07	35614		Y		0.0017	LITCHFIELD	09005	Second													
110187	11	12060	LUGAR			0.1	LUMPKIN	13187	Third													
150030	15	26900	LUGAR			0.0682	HENRY	18065	First													
150076	15	43780	LUGAR			0.0409	MARSHALL	18099	First													
150180	15	43780	LUGAR			0.0409	MARSHALL	18099	First													
160032	16	19780	LUGAR			0.0447	JASPER	19099	Third													
170014	17	28140	LUGAR			0.0513	FRANKLIN	20059	First													
180025	18	31140	LUGAR			0.0375	NELSON	21179	Third													
230005	23	11460	LUGAR		Y	0.0711	LENAWEE	26091	First													
240018	24	33460	LUGAR			0.1	GOODHUE	27049	First													
240071	24	33460		Y		0.0823	RICE	27131	First													
330235	33	45060	LUGAR		Y	0.034	CAYUGA	36011	First													
340126	34	39580		Y		0.0368	WILSON	37195	First													
340127	34	20500	LUGAR			0.0943	GRANVILLE	37077	Second													
390030	39	39740	LUGAR			0.0522	SCHUYLKILL	42107	Second													
390031	39	39740	LUGAR			0.0522	SCHUYLKILL	42107	Second													
390071	39	44300		Y		0.0352	CLINTON	42035	Third													
390183	39	39740	LUGAR		Y	0.0522	SCHUYLKILL	42107	Second													
420030	42	16700	LUGAR		Y	0.0102	COLLETON	45029	First													
450192	45	19124		Y		0.0536	HILL	48217	First													
520102	52	29404		Y		0.0484	WALWORTH	55127	First													
