This bill proposes to amend the Social Security Act, establishing a payment floor for sole community hospitals located in Alaska and Hawaii under the Medicare hospital outpatient prospective payment system. This ensures that if payments for covered outpatient department (OPD) services are less than 94 percent of a hospital's reasonable costs, the payment amount will be increased by the difference. This critical measure aims to provide financial stability for these remote hospitals, preventing underpayment for essential services. The bill specifies that these additional payments will operate without regard to budget neutrality and will not affect patient copayment amounts . The Secretary is directed to promulgate regulations within six months of enactment, with the new rules applying to services furnished on or after the first January 1 following that date.