[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4258 Introduced in House (IH)]

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119th CONGRESS
  1st Session
                                H. R. 4258

     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

                             June 30, 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 if the facility--
                                    ``(I) is located on a reservation 
                                (as defined in section 4 of the Indian 
                                Health Care Improvement Act); and
                                    ``(II) is located more than a 35-
                                mile drive (or, in the case of 
                                mountainous terrain or in areas with 
                                only secondary roads available, a 15-
                                mile drive) from a hospital, or another 
                                facility described in this subsection, 
                                that--
                                            ``(aa) is located on a 
                                        reservation (as so defined); or
                                            ``(bb) is operated by the 
                                        Indian Health Service, an 
                                        Indian tribe or tribal 
                                        organization, or an urban 
                                        Indian organization (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.''.
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