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Beginning with FY 2024, we include hospitals with 412.103 reclassification along with geographically rural hospitals in all rural wage index calculations, and to exclude dual reclass hospitals (hospitals with simultaneous 412.103 and Medicare Geographic Classification Review Board (MGCRB) reclassifications) implicated by the hold harmless provision at section ( 1886(d)(8)(C)(ii) of the Act (88 FR 58971 through 58973)