Holding Nonprofit Hospitals Accountable Act
Sponsored By: Representative Spartz
Introduced
Summary
This bill would require nonprofit hospitals to meet a new community benefit spending test tied to the value of their tax exemptions and align financial-assistance billing with Medicare rates.
Show full summary
- Patients and families: Financial-assistance policies would be tied to Medicare rates for billing, and free or discounted care would count toward hospitals' community benefit obligations.
- Nonprofit hospitals: Hospitals that have community-based boards and serve Medicare and Medicaid patients would need to spend at least 100 percent of the value of their federal, state, and local tax exemptions each taxable year on training, research, facility or equipment improvements, or free/discounted care. No more than 50 percent of that minimum could be spent on facility or equipment improvements and purchases of other care delivery organizations would not count as improvements.
- Oversight and reporting: The Treasury Inspector General for Tax Administration would review financial-assistance policies and report to congressional tax committees within 365 days and annually after that. The Comptroller General would review IRS enforcement of the new standard within 365 days and then every three years.
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Bill Overview
Analyzed Economic Effects
2 provisions identified: 2 benefits, 0 costs, 0 mixed.
New community spending rules for nonprofit hospitals
This bill would set new rules for tax‑exempt hospitals. Each year, they would have to spend at least the full value of their federal, state, and local tax breaks on community benefits. That spending could fund training and research, upgrades to facilities and equipment, and free or discounted care, but no more than half could be for facilities or equipment. Buying other clinics or practices would not count toward the requirement. Hospitals would need community members on their boards and would need to treat Medicare and Medicaid patients without limiting their numbers at any site they own or control. These changes would start for taxable years beginning after December 31, 2025.
Medicare rates for hospital financial help
The bill would make hospitals use Medicare rates when they set the amounts billed in their financial assistance policies. If you qualify for a hospital’s financial help, this could lower the charges used to decide your discount. This would apply for taxable years beginning after December 31, 2025.
Sponsors & CoSponsors
Sponsor
Spartz
IN • R
Cosponsors
There are no cosponsors for this bill.
Roll Call Votes
No roll call votes available for this bill.
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