HR4345-119

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, 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). 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). (F)Hospitals on Indian reservations (i)In generalBeginning 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 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. 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)..