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We note, as discussed in section III.G.1 of the preamble of this proposed rule, we are proposing to include hospitals with 412.103 reclassification along with geographically rural hospitals in all rural wage index calculations, and to only exclude dual reclass hospitals (hospitals with simultaneous 412.103 and MGCRB reclassifications) when implicated by the hold harmless provision at section 1886(d)(8)(C)(ii) of the Act

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These lesions, if unrepaired or mis-repaired, may lead to genetic mutations in surviving cells