# 119-hr-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.

119-hr-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., is a 119th Congress bill sponsored by Rep. Newhouse, Dan [R-WA-4] (R-WA); status introduced; PRIA reads it as touching household money (as of 2026-04-21).

- Canonical: https://policyrisk.com/legislation/119-hr-4258
- As of: 2026-04-21
- Plain-text twin of the page above; the HTML and this file carry the same facts.

## Facts
- Bill: 119-hr-4258
- Congress: 119
- Title: 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.
- Status: introduced
- Introduced: 2025-06-30
- Sponsor: Rep. Newhouse, Dan [R-WA-4] (R-WA)
- Cosponsors: 0
- Policy area: Native Americans
- Touches household money: yes
- Last recorded action: 2026-04-21

## Summary

**Expand Medicare’s critical access hospital designation to certain hospitals on Indian reservations.** The bill would let States designate reservation facilities as CAHs beginning August 1, 2025, set a 35-mile drive rule with a 15-mile exception for mountainous or secondary-road areas, and allow psychiatric and rehabilitation units to operate as distinct parts without the usual CAH bed limit. - Tribal and Indian Health Service facilities: Could become eligible for CAH designation if they meet the reservation location and distance tests, including the 35-mile and 15-mile exceptions. - Residents of reservations: More local hospitals could qualify as Medicare-designated CAHs, changing which facilities a community can have recognized under the CAH framework. - Mental health and rehabilitation patients: Reservation hospitals that qualify could establish psychiatric and rehab distinct part units without being subject to the usual CAH bed-count limit.

## Provisions PRIA read

- Medicare critical access for reservation hospitals: benefit, medium. Starting August 1, 2025, states would be able to name some hospitals on Indian reservations as Medicare critical access hospitals. The hospital would have to be on a reservation and more than a 35‑mile drive from the nearest qualifying hospital. In mountains or where only secondary roads exist, the…

## Related bills

- 119-hr-9237: Take Care of America’s Veterans Act
- 119-hr-4393: DIGNIDAD (Dignity) Act of 2025
- 119-hr-2725: Affordable Housing Credit Improvement Act of 2025
- 119-hr-3227: Farm Workforce Modernization Act of 2025
- 119-hr-471: Fix Our Forests Act
- 119-hr-2709: Save Our Sequoias Act

## Sources
- [119-hr-4258 on Congress.gov](https://www.congress.gov/bill/119th-congress/house-bill/4258)

## Related
- [119-hr-9237: Take Care of America’s Veterans Act](https://policyrisk.com/legislation/119-hr-9237)
- [119-hr-4393: DIGNIDAD (Dignity) Act of 2025](https://policyrisk.com/legislation/119-hr-4393)
- [119-hr-2725: Affordable Housing Credit Improvement Act of 2025](https://policyrisk.com/legislation/119-hr-2725)
- [119-hr-3227: Farm Workforce Modernization Act of 2025](https://policyrisk.com/legislation/119-hr-3227)
- [119-hr-471: Fix Our Forests Act](https://policyrisk.com/legislation/119-hr-471)
- [119-hr-2709: Save Our Sequoias Act](https://policyrisk.com/legislation/119-hr-2709)
- [All bills in Congress](https://policyrisk.com/legislation)

Source: PRIA, https://policyrisk.com/legislation/119-hr-4258 (as of 2026-04-21).