; (I) notifies the Secretary at such time and in such manner as the Secretary may require of the intent of such facility to be designated as a community outpatient facility; and (J) meets such staff training and certification requirements as the Secretary may require. (2) Nothing in this subsection or section 1834(r) shall be construed to prohibit a community outpatient hospital from having an agreement under section 1883 for the provision of extended care services. (3) Unless the context otherwise requires, a reference to a community outpatient hospital in this title shall be deemed to also be a reference to a critical access hospital. (jjj) Qualified outpatient services The term qualified outpatient services means medical and other health services furnished on an outpatient basis by a community outpatient hospital, rural health clinic (as defined in section 1861(aa)(2)), federally qualified health center (as defined in section 1861(aa)(4)), or an entity certified by the Health Resources and Services Administration as a federally qualified health center look-alike, including, for individuals who require services from a hospital or critical access hospital, transportation services from such community outpatient hospital to a hospital or critical access hospital. . (2) Payment for qualified outpatient services Section 1834 of the Social Security Act ( 42 U.S.C. 1395m ) is amended by adding at the end the following: (r) Payment for qualified outpatient services (1) In general The amount of payment for qualified outpatient services is equal to 105 percent of the reasonable costs of providing such services. (2) Telehealth services as reasonable costs For purposes of this subsection, with respect to qualified outpatient services, costs reasonably associated with having a backup physician available via a telecommunications system shall be considered reasonable costs. . (b) Waiver of distance requirement for replacement CAHs