Sponsor
Daniel Milton Newhouse
Representative · R-WA
Representative · R-WA
The bill improves access to and financial viability of inpatient and behavioral health services for tribal and remote communities by allowing reservation facilities to become CAHs, at the cost of higher Medicare/taxpayer spending and potential shifts away from outpatient/community services plus modest state administrative burdens.
Residents of Indian reservations and other nearby rural communities would gain more local access to inpatient hospital care because reservation facilities located >35 miles (or >15 miles in mountainous/secondary‑road areas) from another hospital can be designated as Critical Access Hospitals (CAHs).
Reservation health facilities (serving tribal and rural populations) would receive increased federal Medicare reimbursement and cost‑based payments after CAH designation, improving their financial stability and ability to continue serving remote communities.
Patients on reservations, including those with behavioral health or rehabilitation needs, would be able to access local psychiatric and rehabilitation distinct‑part inpatient units without the usual small‑hospital bed limits, expanding available local behavioral health and rehab services.
Taxpayers and the Medicare program could face higher costs if more facilities obtain CAH status and receive higher reimbursements or cost‑based payments.
Some tribal communities and patients with chronic or behavioral health needs might see a shift in resources toward small inpatient psychiatric/rehabilitation units rather than expanded outpatient or community‑based services, which some stakeholders prefer.
State health agencies would have to exercise designation authority to approve CAH status for reservation facilities, creating modest additional administrative burden for states.
Based on analysis of 2 sections of legislative text.
Permits facilities on Indian reservations that meet distance tests to be designated as Medicare CAHs starting Aug 1, 2025, and waives bed limits for psych/rehab units.
Official 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.
Introduced June 30, 2025 by Daniel Milton Newhouse · Last progress June 30, 2025
Allows certain health facilities located on Indian reservations to be designated as Medicare Critical Access Hospitals (CAHs) beginning August 1, 2025, when they meet distance requirements from other hospitals. It also permits those reservation-based CAHs to establish psychiatric or rehabilitation distinct-part units without being subject to the usual bed-number limit for such units, easing access to inpatient behavioral health and rehab services in remote tribal communities.