This bill amends title XVIII (Medicare) of the Social Security Act to specify that, for purposes of determining Medicare payment and reasonable costs for both inpatient and outpatient critical access hospital (CAH) services, the Centers for Medicare & Medicaid Services (CMS) shall recognize as allowable costs those related to specified emergency, diagnostic, anesthetist, community health, and off-campus clinical services.

Furthermore, in determining payment and reasonable costs for both inpatient and outpatient CAH services, CMS shall not disallow payment to a CAH on the basis that such payment offsets the cost of a current permissible health care-related tax imposed on and paid by the CAH. CMS must make specified payment adjustments to account for such a tax. 

Generally, under current law, a facility must be located beyond a specified driving distance from another hospital or facility in order to be designated as a CAH. The bill specifies that this requirement does not apply with respect to a CAH's off-campus provider-based clinic.

Current law further requires a facility to provide certain 24-hour emergency care services as a condition of designation as a CAH. The bill allows CMS to waive this requirement with respect to a facility that coordinates with a nearby facility or hospital that provides such services.