# 119-hr-4345: 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-4345, 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-4345
- 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-4345
- 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: 2025-07-10
- Sponsor: Rep. Newhouse, Dan [R-WA-4] (R-WA)
- Cosponsors: 0
- Policy area: Health
- Touches household money: yes
- Last recorded action: 2026-04-21

## Summary

**This bill would expand Critical Access Hospital eligibility to include hospitals located on Indian reservations.** It would let states designate reservation facilities as CAHs without regard to the usual geographic distance limits and would allow psychiatric and rehabilitation distinct part units without counting toward CAH bed limits, beginning August 1, 2025. - Tribal hospitals and reservation facilities: Would be eligible for Critical Access Hospital designation even if they do not meet the usual distance-to-hospital rules. This change starts August 1, 2025. - Psychiatric and rehabilitation units: A reservation CAH could create distinct part psychiatric or rehab units without the normal bed-count limit, and those units would not be counted when determining the hospital's primary services. - State health agencies: Would have authority to designate qualifying reservation facilities as CAHs under the amended rules. - Patients in tribal communities: Could gain closer inpatient care and more local behavioral health and rehabilitation options.

## Provisions PRIA read

- More Medicare hospital options on reservations: benefit, low. If enacted, starting August 1, 2025, a state could name a hospital on an Indian reservation as a Medicare critical access hospital even if it is near another hospital. These hospitals could add psychiatric and rehab units without the usual bed cap. Federal officials would not count those units when…

## 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-4345 on Congress.gov](https://www.congress.gov/bill/119th-congress/house-bill/4345)

## 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-4345 (as of 2026-04-21).