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.

#4345 | HR Congress #119

Policy Area: Health
Subjects:

Last Action: Referred to the House Committee on Ways and Means. (7/10/2025)

Bill Text Source: Congress.gov

Summary and Impacts
Original Text

Bill Summary

This legislation seeks to amend the Social Security Act to expand the definition of "critical access hospital" within the Medicare program to include certain hospitals located on Indian reservations. The key provisions include:

1. **Designation Flexibility**: Starting August 1, 2025, states will have the authority to designate hospitals on Indian reservations as critical access hospitals regardless of their distance from other healthcare facilities. This aims to address the unique healthcare challenges faced by these communities.

2. **Distinct Part Units**: The legislation allows these designated hospitals to establish distinct part units for psychiatric and rehabilitation services without being restricted by the current limitations on the number of beds. This is intended to enhance service delivery in these critical areas for patients.

Overall, the bill aims to improve access to essential healthcare services for Native American populations by recognizing and accommodating the specific needs of hospitals on reservations.

Possible Impacts

Here are three examples of how the proposed legislation to expand the definition of critical access hospitals under the Medicare program to include certain hospitals on Indian reservations could affect people:

1. **Improved Access to Healthcare**: The amendment would allow hospitals located on Indian reservations to be designated as critical access hospitals, which could enhance access to essential medical services for Native American populations. This would potentially lead to increased availability of healthcare services in remote areas, reducing travel time and costs for patients who previously had to go to distant facilities for care.

2. **Increased Funding and Resources**: By qualifying as critical access hospitals, the facilities on Indian reservations may receive additional federal funding and resources. This financial support could help improve the infrastructure, technology, and staffing of these hospitals, leading to better quality care and more comprehensive health services for the communities they serve.

3. **Enhanced Mental Health Services**: The legislation allows facilities on reservations to establish distinct part units for psychiatric and rehabilitation services without strict limitations on the number of beds. This could lead to an expansion of mental health services available to Native American populations, addressing the significant mental health challenges faced by these communities, and offering more tailored and accessible treatment options for individuals in need.

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4345 Introduced in House (IH)]

<DOC>






119th CONGRESS
  1st Session
                                H. R. 4345

     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.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             July 10, 2025

 Mr. Newhouse introduced the following bill; which was referred to the 
                      Committee on Ways and Means

_______________________________________________________________________

                                 A BILL


 
     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.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

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).''.
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