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 (HR 4345) expands Medicare's definition of "critical access hospitals" to include certain hospitals located on Indian reservations, effective August 1, 2025. It directly affects these reservation hospitals by allowing states to designate them as critical access hospitals without needing to meet the usual distance requirement from other hospitals. Key provisions include waiving the distance rule for reservation facilities and permitting them to establish psychiatric or rehabilitation units without being limited by the standard bed count restrictions. This change aims to improve access to Medicare-covered services for patients at these reservation hospitals.