To amend title XVIII of the Social Security Act to provide for a permanent hold harmless provision for sole community hospitals under the Medicare prospective payment system for covered outpatient department services.

Amends title XVIII (Medicare) of the Social Security Act to provide for a permanent hold harmless provision for sole community hospitals under the Medicare prospective payment system (PPS) for covered outpatient department (OPD) services.

Declares that, in the case of a sole community hospital for covered OPD services furnished after December 31, 2005, for which the PPS amount is less than the pre-BBA amount, the amount of payment shall be increased by the amount of such difference.

(Pre-BBA amount means an amount equal to the product of the reasonable cost of the hospital for such services for the portions of the hospital's cost reporting period (or periods) occurring in the year and the base OPD payment-to-cost ratio for the hospital.)