Because the Office of Management and Budget has revised its Metropolitan and Micropolitan statistical areas (see the February 28th OMB Bulletin), there are 104 counties that were changed from nonmetropolitan to metropolitan. This could have an important impact on the 44 Critical Access Hospitals located in those counties, which could lose their CAH status and have to transition to PPS payments. In addition, because of this revision, dozens of formerly rural counties may lose their telehealth Medicare benefits.