1. Short title This Act may be cited as the Rural Emergency Medical Center Act of 2018 or the REMC Act of 2018 . 2. Medicare rural emergency medical centers and services (a) In general (1) Rural emergency medical center and services defined Section 1861 of the Social Security Act ( 42 U.S.C. 1395x ) is amended— (A) in subsection (e), in the last sentence of the matter following paragraph (9), by inserting or a rural emergency medical center (as defined in subsection (jjj)(1)) before the period at the end; and (B) by adding at the end the following subsection: (jjj) Rural Emergency Medical Center; Rural Emergency Medical Center Services (1) The term rural emergency medical center means a facility that— (A) (i) as of the date of the enactment of this subsection— (I) was a critical access hospital; or (II) was a hospital with not more than 50 beds located in a county (or equivalent unit of local government) in a rural area (as defined in section 1886(d)(2)(D)), or was a hospital with not more than 50 beds that was treated as being located in a rural area pursuant to section 1886(d)(8)(E); or (ii) was a critical access hospital described in clause (i)(I) or a hospital described in clause (i)(II) that ceased operations during the period beginning on the date that is 5 years prior to the date of the enactment of this subsection and ending on the date of the enactment of this subsection; (B) provides 24-hour emergency medical care and observation care that does not exceed an annual per patient average of 24 hours or more than 1 midnight; (C) may include a unit of the facility that is licensed as a distinct part skilled nursing facility; (D) does not provide any acute care inpatient beds and has protocols in place for the timely transfer of patients who require acute care inpatient services or other inpatient services