H.R. 4258

[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.

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IN THE HOUSE OF REPRESENTATIVES

June 30, 2025

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

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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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