,i  #aaith ,,congress  #ast ,session    
,h4 ,r4 #dcde  ,,in ,,the ,,house ,,of  
,,representatives  ,july #aj1 #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 hospital1 without 
regard to the distance between the      
facility and a hospital 7or another     
facility described in this subsection71 
if the facility is located on a         
reservation 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 ,the  
,secretary may not take a distinct part 
unit so established by such facility    
into account when determining whether   
such facility is primarily engaged in   
providing the services described in     
section #ahfa7;e77#a74  4