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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Committee
Latest Action · July 10, 2025
Referred to the House Committee on Ways and Means.
H.R. 4345 modifies Medicare's definition of "critical access hospital" to allow hospitals located on Indian reservations to qualify for this designation without meeting the usual distance requirements that apply to other hospitals. Currently, critical access hospitals must meet certain geographic distance thresholds to receive this special Medicare status, but this bill exempts reservation-based hospitals from those restrictions, effective August 1, 2025. The bill also allows these hospitals to establish psychiatric and rehabilitation units with greater flexibility in bed capacity limits than is normally permitted. This change primarily affects Indian tribes and Native American communities by giving their hospitals easier access to critical access hospital status, which comes with special Medicare payment rates and other federal support. The legislation does not include specific funding amounts but enables states to designate qualifying reservation hospitals under the expanded eligibility rules.
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