HR4258-119

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— in subparagraph (B)(i)(I), by inserting subject to subparagraph (F), before is located; in subparagraph (E)(ii), by striking The total and inserting Subject to subparagraph (F), the total; and by adding at the end the following new subparagraph: Beginning August 1, 2025, a State may designate a facility as a critical access hospital if the facility— is located on a reservation (as defined in section 4 of the Indian Health Care Improvement Act); and 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— is located on a reservation (as so defined); or 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). 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. (F)Hospitals on Indian reservations (i)In generalBeginning 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 unitsA 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..