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Supported by the Intramural Research Program of the National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892

Courts have repeatedly held unlawful CMS wage index and floor policies that do not treat 412.103 hospitals the same as geographically rural hospitals based on section 1886(d)(8)(E)(i) of the Act, which requires that the Secretary shall treat the [ 412.103] hospital as being located in the rural area. For example, on July 23, 2015, the U.S

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