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IRS releases Draft Schedule H, instructions for tax-exempt hospitals

Posted on January 6, 2012 | No Comments

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The Internal Revenue Service (IRS) has issued a draft Schedule H and accompanying instructions for tax-exempt hospitals. As required by the Affordable Care Act (ACA), non-profit hospitals must respond to questions on financial assistance policies, billing and collection practices, emergency medical care, and individuals eligible for financial assistance, beginning with the 2011 tax filing year. The draft instructions have been revised to more clearly follow the statutory provision of Section 501(r) of the Internal Revenue Code. Several of the changes relate to billing and collections.

For more information on tax-exempt hospital requirements, click here and here.

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On July 7, 2011, the Treasury Department and the Internal Revenue Service (IRS) published a Notice and Request for Comments on a proposed policy regarding the Affordable Care Act’s new requirements related to tax exempt hospitals’ community health needs assessment (CHNA) obligations. Section 9007 of the Act added new Section 501(r) to the Internal Revenue Code, which delineates a series of statutory requirements, outlined in a previous implementation brief, applicable to nonprofit hospitals that seek tax-exempt status under Section 501(c)(3). The purpose of the Treasury/IRS Notice is to both describe the agencies’ approach to implementing hospital organizations’ CHNA obligations and to invite comments regarding their proposals. The CHNA requirements are effective for taxable years beginning after March 23, 2012. However, the Notice specifies that hospitals currently engaged in conducting CHNA-related activities -- including development and wide publication of a needs assessment and adoption of an implementation strategy -- can rely on the policies contained in the Notice as they move forward.
This implementation brief examines the addition of Section 501(r) to the Internal Revenue Code under the Affordable Care Act (ACA), which sets out new requirements for not-for-profit, tax-exempt hospitals.
On July 7, 2011, the Treasury Department and the Internal Revenue Service (IRS) published a Notice and Request for Comments on a proposed policy regarding the Affordable Care Act’s new requirements related to tax exempt hospitals’ community health needs assessment (CHNA) obligations. Section 9007 of the Act added new Section 501(r) to the Internal Revenue Code, which delineates a series of statutory requirements, outlined in a previous implementation brief, applicable to nonprofit hospitals that seek tax-exempt status under Section 501(c)(3). The purpose of the Treasury/IRS Notice is to both describe the agencies’ approach to implementing hospital organizations’ CHNA obligations and to invite comments regarding their proposals. The CHNA requirements are effective for taxable years beginning after March 23, 2012. However, the Notice specifies that hospitals currently engaged in conducting CHNA-related activities -- including development and wide publication of a needs assessment and adoption of an implementation strategy -- can rely on the policies contained in the Notice as they move forward.
The Internal Revenue Service (IRS) has issued a notice and request for comment (RFC) on the community health needs assessment requirement, which was established by the Affordable Care Act (ACA). Part of a broader group of new rules and requirements for certain tax-exempt, 501(r) organizations, the community health needs assessment (CHNA) must be done every 3 years by the tax-exempt hospital. The CHNA must be made available to the public and include an "implementation strategy" that focuses on the particular health needs of the communities that these not-for-profit hospitals serve.
In Notice 2010-39, the Internal Revenue Service solicits comment on new requirements for tax-exempt hospitals under the health reform law.
Section 501(r) is Congress’ first attempt since 1969 to put more “teeth” into the exemption standards for tax-exempt hospitals. While well-meaning, the statute is poorly drafted and leaves the IRS in a difficult position of having to administer a statute with significant structural problems.