Appalachian Communities Health Emergency Act or ACHE Act - Requires the Director of the National Institute of Environmental Health Sciences to conduct or support comprehensive studies on the health impacts of mountaintop removal coal mining on individuals in the surrounding communities. Directs the Secretary of Health and Human Services (HHS), upon receipt of a report on study results, to publish a determination of whether such mining presents any health risks to individuals in those communities. Defines "mountaintop removal coal mining" as surface coal mining that uses blasting with explosives in the steep slope regions of Kentucky, Tennessee, West Virginia, and Virginia.

Prohibits issuance of an authorization for any mountaintop removal coal mining project (or expansion), under the Federal Water Pollution Control Act (commonly known as the Clean Water Act) or the Surface Mining Control and Reclamation Act of 1977, until and unless the Secretary publishes a determination that such mining does not present any health risk to individuals in the surrounding communities. Imposes requirements for continuous monitoring of air, noise, and water pollution and frequent monitoring of soil until a determination by the Secretary is made.

Directs the President, acting through the Office of Surface Mining Reclamation and Enforcement of the Department of the Interior, to assess a one-time fee upon persons that conduct such mining projects, sufficient to cover the federal cost of the health studies and pollution monitoring required by this Act.