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<dc:title>119 HR 4345 IH: 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.</dc:title>
<dc:publisher>U.S. House of Representatives</dc:publisher>
<dc:date>2025-07-10</dc:date>
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<dc:language>EN</dc:language>
<dc:rights>Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.</dc:rights>
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<distribution-code display="yes">I</distribution-code><congress display="yes">119th CONGRESS</congress><session display="yes">1st Session</session><legis-num display="yes">H. R. 4345</legis-num><current-chamber>IN THE HOUSE OF REPRESENTATIVES</current-chamber><action display="yes"><action-date date="20250710">July 10, 2025</action-date><action-desc><sponsor name-id="N000189">Mr. Newhouse</sponsor> introduced the following bill; which was referred to the <committee-name committee-id="HWM00">Committee on Ways and Means</committee-name></action-desc></action><legis-type>A BILL</legis-type><official-title display="yes">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.</official-title></form><legis-body id="HDD0DCB83C3674B8FA5AC96BF8FD603A8" style="OLC"> 
<section id="HF17CB904AE274247AC5008CCDDAFDEAA" section-type="section-one"><enum>1.</enum><header>Expanding the definition of critical access hospital under the Medicare program to include certain hospitals on Indian reservations</header> <text display-inline="no-display-inline">Section 1820(c)(2) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395i-4">42 U.S.C. 1395i–4(c)(2)</external-xref>) is amended—</text> <paragraph id="H4C06423E13B74A8AA51F72543549B5DA"><enum>(1)</enum><text>in subparagraph (B)(i)(I), by inserting <quote>subject to subparagraph (F),</quote> before <quote>is located</quote>;</text> </paragraph> 
<paragraph id="H37FBEF65490C4F53A0A486FE7CA547F3"><enum>(2)</enum><text>in subparagraph (E)(ii), by striking <quote>The total</quote> and inserting <quote>Subject to subparagraph (F), the total</quote>; and</text> </paragraph> <paragraph id="HDB704305DC444C42BB229CA09393B883"><enum>(3)</enum><text>by adding at the end the following new subparagraph:</text> 
<quoted-block style="OLC" id="HDC02DABA9D4541748071A2AD9B88C835" display-inline="no-display-inline"> 
<subparagraph id="H0084BF4EF9974D2EA19BFE27B4D7A042"><enum>(F)</enum><header>Hospitals on Indian reservations</header> 
<clause id="H3B22E3381B9546299983B7ABB5D83E81"><enum>(i)</enum><header>In general</header><text display-inline="yes-display-inline">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).</text> </clause> <clause id="H17774026452341FE9C998F26CE5533F5"><enum>(ii)</enum><header>Psychiatric and rehabilitation distinct part units</header><text display-inline="yes-display-inline">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).</text></clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></section> 
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