Sec. 9007. ADDITIONAL REQUIREMENTS FOR CHARITABLE HOSPITALS
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## SEC. 9007 ADDITIONAL REQUIREMENTS FOR CHARITABLE HOSPITALS ###
(a)Requirements To Qualify as Section 501(c)(3) Charitable Hospital Organization Section 501 of the Internal Revenue Code of 1986 (relating to exemption from tax on corporations, certain trusts, etc.) is amended by redesignating subsection
(r)as subsection
(s)and by inserting after subsection
(q)the following new subsection: > > ### “(r) Additional Requirements for Certain Hospitals > > > #### “(1) In general > > A hospital organization to which this subsection applies shall not be treated as described in subsection (c)(3) unless the organization— > > > ##### “(A) > > meets the community health needs assessment requirements described in paragraph (3), > > > ##### “(B) > > meets the financial assistance policy requirements described in paragraph (4), > > > ##### “(C) > > meets the requirements on charges described in paragraph (5), and > > > ##### “(D) > > meets the billing and collection requirement described in paragraph (6). > > > #### “(2) Hospital organizations to which subsection applies > > > ##### “(A) In general > > This subsection shall apply to— > > > ###### “(i) > > an organization which operates a facility which is required by a State to be licensed, registered, or similarly recognized as a hospital, and > > > ###### “(ii) > > any other organization which the Secretary determines has the provision of hospital care as its principal function or purpose constituting the basis for its exemption under subsection (c)(3) (determined without regard to this subsection). > > > ##### “(B) Organizations with more than 1 hospital facility > > If a hospital organization operates more than 1 hospital facility— > > > ###### “(i) > > the organization shall meet the requirements of this subsection separately with respect to each such facility, and > > > ###### “(ii) > > the organization shall not be treated as described in subsection (c)(3) with respect to any such facility for which such requirements are not separately met. > > > #### “(3) Community health needs assessments > > > ##### “(A) In general > > An organization meets the requirements of this paragraph with respect to any taxable year only if the organization— > > > ###### “(i) > > has conducted a community health needs assessment which meets the requirements of subparagraph
(B)in such taxable year or in either of the 2 taxable years immediately preceding such taxable year, and > > > ###### “(ii) > > has adopted an implementation strategy to meet the community health needs identified through such assessment. > > > ##### “(B) Community health needs assessment > > A community health needs assessment meets the requirements of this paragraph if such community health needs assessment— > > > ###### “(i) > > takes into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health, and > > > ###### “(ii) > > is made widely available to the public. > > > #### “(4) Financial assistance policy > > An organization meets the requirements of this paragraph if the organization establishes the following policies: > > > ##### “(A) Financial assistance policy > > A written financial assistance policy which includes— > > > ###### “(i) > > eligibility criteria for financial assistance, and whether such assistance includes free or discounted care, > > > ###### “(ii) > > the basis for calculating amounts charged to patients, > > > ###### “(iii) > > the method for applying for financial assistance, > > > ###### “(iv) > > in the case of an organization which does not have a separate billing and collections policy, the actions the organization may take in the event of non-payment, including collections action and reporting to credit agencies, and > > > ###### “(v) > > measures to widely publicize the policy within the community to be served by the organization. > > > ##### “(B) Policy relating to emergency medical care > > A written policy requiring the organization to provide, without discrimination, care for emergency medical conditions (within the meaning of section 1867 of the Social Security Act (42 U.S.C. 1395dd)) to individuals regardless of their eligibility under the financial assistance policy described in subparagraph (A). > > > #### “(5) Limitation on charges > > An organization meets the requirements of this paragraph if the organization— > > > ##### “(A) > > limits amounts charged for emergency or other medically necessary care provided to individuals eligible for assistance under the financial assistance policy described in paragraph (4)(A) to not more than the amounts generally billed to individuals who have insurance covering such care, and > > > ##### “(B) > > prohibits the use of gross charges. > > > #### “(6) Billing and collection requirements > > An organization meets the requirement of this paragraph only if the organization does not engage in extraordinary collection actions before the organization has made reasonable efforts to determine whether the individual is eligible for assistance under the financial assistance policy described in paragraph (4)(A). > > > #### “(7) Regulatory authority > > The Secretary shall issue such regulations and guidance as may be necessary to carry out the provisions of this subsection, including guidance relating to what constitutes reasonable efforts to determine the eligibility of a patient under a financial assistance policy for purposes of paragraph (6).” > . ###
(b)Excise Tax for Failures To Meet Hospital Exemption Requirements ####
(1)In general Subchapter D of chapter 42 of the Internal Revenue Code of 1986 (relating to failure by certain charitable organizations to meet certain qualification requirements) is amended by adding at the end the following new section: > > ## “SEC. 4959 TAXES ON FAILURES BY HOSPITAL ORGANIZATIONS > > “If a hospital organization to which section 501(r) applies fails to meet the requirement of section 501(r)(3) for any taxable year, there is imposed on the organization a tax equal to $50,000.” > . ####
(2)Conforming amendment The table of sections for subchapter D of chapter 42 of such Code is amended by adding at the end the following new item: ''Sec. 4959. Taxes on failures by hospital organizations.''. ###
(c)Mandatory Review of Tax Exemption for Hospitals **[**[26 U.S.C. 501 note](/us/usc/t26/s501)**]** The Secretary of the Treasury or the Secretary's delegate shall review at least once every 3 years the community benefit activities of each hospital organization to which section 501(r) of the Internal Revenue Code of 1986 (as added by this section) applies. ###
(d)Additional Reporting Requirements ####
(1)Community health needs assessments and audited financial statements Section 6033(b) of the Internal Revenue Code of 1986 (relating to certain organizations described in section 501(c)(3)) is amended by striking “ and ” at the end of paragraph (14), by redesignating paragraph
(15)as paragraph (16), and by inserting after paragraph
(14)the following new paragraph: > > #### “(15) > > in the case of an organization to which the requirements of section 501(r) apply for the taxable year— > > > ##### “(A) > > a description of how the organization is addressing the needs identified in each community health needs assessment conducted under section 501(r)(3) and a description of any such needs that are not being addressed together with the reasons why such needs are not being addressed, and > > > ##### “(B) > > the audited financial statements of such organization (or, in the case of an organization the financial statements of which are included in a consolidated financial statement with other organizations, such consolidated financial statement).” > . ####
(2)Taxes Section 6033(b)(10) of such Code is amended by striking “ and ” at the end of subparagraph (B), by inserting “ and ” at the end of subparagraph (C), and by adding at the end the following new subparagraph: > > ##### “(D) > > section 4959 (relating to taxes on failures by hospital organizations),” > . ###
(e)Reports **[**[26 U.S.C. 501 note](/us/usc/t26/s501)**]** ####
(1)Report on levels of charity care The Secretary of the Treasury, in consultation with the Secretary of Health and Human Services, shall submit to the Committees on Ways and Means, Education and Labor, and Energy and Commerce of the House of Representatives and to the Committees on Finance and Health, Education, Labor, and Pensions of the Senate an annual report on the following: #####
(A)Information with respect to private tax-exempt, taxable, and government-owned hospitals regarding— ######
(i)levels of charity care provided, ######
(ii)bad debt expenses, ######
(iii)unreimbursed costs for services provided with respect to means-tested government programs, and ######
(iv)unreimbursed costs for services provided with respect to non-means tested government programs. #####
(B)Information with respect to private tax-exempt hospitals regarding costs incurred for community benefit activities. ####
(2)Report on trends #####
(A)Study The Secretary of the Treasury, in consultation with the Secretary of Health and Human Services, shall conduct a study on trends in the information required to be reported under paragraph (1). #####
(B)Report Not later than 5 years after the date of the enactment of this Act, the Secretary of the Treasury, in consultation with the Secretary of Health and Human Services, shall submit a report on the study conducted under subparagraph
(A)to the Committees on Ways and Means, Education and Labor, and Energy and Commerce of the House of Representatives and to the Committees on Finance and Health, Education, Labor, and Pensions of the Senate. ###
(f)Effective Dates **[**[26 U.S.C. 501 note](/us/usc/t26/s501)**]** ####
(1)In general Except as provided in paragraphs
(2)and (3), the amendments made by this section shall apply to taxable years beginning after the date of the enactment of this Act. ####
(2)Community health needs assessment The requirements of section 501(r)(3) of the Internal Revenue Code of 1986, as added by subsection (a), shall apply to taxable years beginning after the date which is 2 years after the date of the enactment of this Act. ####
(3)Excise tax The amendments made by subsection
(b)shall apply to failures occurring after the date of the enactment of this Act.
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