,i  #aaith ,,congress  #ast ,session    
,h4 ,r4 #dbeh  ,,in ,,the ,,house ,,of  
,,representatives  ,june #cj1 #bjbe,mr4 
,newhouse introduced the following bill2
 which was referred to the ,committee on
 ,ways and ,means  ,a ,,bill  ,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 reservations4  #a4 
,expanding the definition of critical   
access hospital under the ,medicare     
program to include certain hospitals on 
,indian reservations ,section           
#ahbj7;c77#b7 of the ,social ,security  
,act 7#db ,u4,s4,c4 #acie;i-#d7;c77#b77 
is amended-- 7#a7 in subparagraph       
7,b77i77,i71 by inserting subject to    
subparagraph 7,f71 before is located2   
7#b7 in subparagraph 7,e77ii71 by       
striking ,the total and inserting       
,subject to subparagraph 7,f71 the      
total2 and  7#c7 by adding at the end   
the following new subparagraph3  7,f7   

,hospitals on ,indian reservations  7i7 
,in general ,beginning ,august #a1      
#bjbe1 a ,state may designate a facility
 as a critical access hospital if the   
facility-- 7,i7 is located on a         
reservation 7as defined in section #d of
 the ,indian ,health ,care ,improvement 
,act72 and  7,,ii7 is located more than 
a #ce-mile drive 7or1 in the case of    
mountainous terrain or in areas with    
only secondary roads available1 a       
#ae-mile drive7 from a hospital1 or     
another facility described in this      
subsection1 that-- 7aa7 is located on a 
reservation 7as so defined72 or  7bb7 is
 operated by the ,indian ,health        
,service1 an ,indian tribe or tribal    
organization1 or an urban ,indian       
organization 7as defined in section #d  
of the ,indian ,health ,care            
,improvement ,act74  7ii7 ,psychiatric  
and rehabilitation distinct part units  
,a facility described in clause 7i7 may 
establish a distinct part unit under    
subparagraph 7,e7 without regard to the 

limitation on number of beds under      
clause 7ii7 of such subparagraph4  4