; (E) has elected to be designated as a rural emergency access center; (F) has been licensed by, or received approval to operate as a qualified emergency medical center from, the State under paragraph (3); and (G) is certified by the Secretary under paragraph (4). (2) The term rural emergency access center services means medical and other health services furnished by a rural emergency access center on an outpatient basis. (3) A facility may not operate as a rural emergency access center unless the facility— (A) is located in a State that provides for the licensing of emergency medical centers under State or applicable local law; and (B) (i) is licensed pursuant to such law; or (ii) is approved by the agency of such State or locality responsible for licensing hospitals, as meeting the standards established for such licensing. (4) The Secretary shall certify a facility as a rural emergency access center if the facility— (A) meets the criteria for rural emergency access center described in subparagraphs (A) through (F) of paragraph (1); (B) has in effect a transfer agreement with a level I or level II trauma center; and (C) meets such staff training and certification requirements as the Secretary may require. (5) A facility certified by the Secretary as a rural emergency access center shall be deemed to be a critical access hospital for purposes of section 340B of the Public Health Service Act. . (2) Payment for rural emergency access center services (A) In general Section 1833(a) of the Social Security Act ( 42 U.S.C. 1395l(a) ) is amended— (i) in paragraph (8), by striking and at the end; (ii) in paragraph (9), by striking the period at the end and inserting ; and