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We are proposing to amend 412.103(d)(1) and to add new 412.103(d)(3) to provide that, subject to the hospital meeting the requirements set forth at proposed 412.92(b)(2)(vi), the effective date for rural reclassification for such hospital would be as of the effective date determined under 412.92(b)(2)(vi)

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Direct beneficiary services include in-kind items or services provided to an ACO beneficiary that are not otherwise covered by Traditional Medicare but are evidence-based and medically appropriate for the beneficiary based on clinical and social risk factors

In contrast, after adsorbing Hg 0 , the S 2p binding energies of the Hg-laden PPS were shifted to 163.4 and 164.6 eV