To amend title XVIII of the Social Security Act to ensure that medicare-dependent, small, rural hospitals receive at least their reasonable costs for inpatient hospital services furnished under the medicare program, and for other purposes.

Amends title XVIII (Medicare) of the Social Security Act to require the Secretary of Health and Human Services to pay additional amounts to Medicare-dependent, small, rural hospitals to ensure that their reasonable operating costs for inpatient hospital services are covered.

Makes the classification of a rural hospital as a rural referral center permanent. Treats any hospital which is the sole source of inpatient hospital services in a county or parish having no more than 10,000 inhabitants as a sole community hospital.