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To amend title XVIII of the Social Security Act to expand the definition of critical access hospital under the Medicare program to include certain hospitals on Indian reservations.

H.R. 4345 · 119th Congress · Jul 10, 2025 · Lineage

A BILL

Section 1 Expanding the definition of critical access hospital under the Medicare program to include certain hospitals on Indian reservations

Section 1820(c)(2) of the Social Security Act (42 U.S.C. 1395i–4(c)(2)) is amended—
(1)
in subparagraph (B)(i)(I), by inserting “subject to subparagraph (F),” before “is located”;
(2)
in subparagraph (E)(ii), by striking “The total” and inserting “Subject to subparagraph (F), the total”; and
(3)
by adding at the end the following new subparagraph:

“(F) Hospitals on Indian reservations

“(i) In general—Beginning August 1, 2025, a State may designate a facility as a critical access hospital, without regard to the distance between the facility and a hospital (or another facility described in this subsection), if the facility is located on a reservation (as defined in section 4 of the Indian Health Care Improvement Act).

“(ii) Psychiatric and rehabilitation distinct part units—A facility described in clause (i) may establish a distinct part unit under subparagraph (E) without regard to the limitation on number of beds under clause (ii) of such subparagraph. The Secretary may not take a distinct part unit so established by such facility into account when determining whether such facility is primarily engaged in providing the services described in section 1861(e)(1).”