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.

This bill would expand Medicare’s critical access hospital (CAH) designation to include certain hospitals located on Indian reservations. Specifically, starting August 1, 2025, a State may designate a facility as a CAH if the facility is located on a reservation and is sufficiently distant from another hospital or CAH (more than 35 miles away, or 15 miles in mountainous terrain or where only secondary roads are available). The distance measurement can reference facilities located on a reservation or operated by the Indian Health Service (IHS), an Indian tribe or tribal organization, or an urban Indian organization. Additionally, the bill would allow psychiatric and rehabilitation services at these facilities to be established as distinct part units without being limited by the usual bed cap that applies to CAHs. In short, the bill expands access to CAH status for rural and tribal hospitals on reservations, with a focus on remote locations, and it loosens constraints for offering psychiatric and rehabilitation care through distinct part units. It would take effect in August 2025 and is currently in the House, referred to the Ways and Means Committee.