title: Revise or preserve? A flurry of views on revision of tax-exemption standards.
abstract: Many groups would be affected if Congress changes the tax laws governing not-for-profit hospitals. The community benefit standard now in place focuses on nondiscriminatory treatment of patients whose care is paid for by public programs such as Medicaid. It also fosters universal access to emergency care regardless of ability to pay. In 1990, however, a U.S. General Accounting Office (GAO) report suggested that if Congress believes tax-exempt hospitals should provide more charity care, it should consider revising the criteria for exemption. This created a flurry of responses from the groups that would be affected. In response to the GAO's report, Rep. Edward R. Roybal, D-CA, introduced H.R. 790, and Rep. Brian J. Donnelly, D-MA, introduced H.R. 1374, bills linking tax exemption to charity care. The Roybal bill requires not-for-profit hospitals to have an open-door policy for Medicare and Medicaid patients and to provide services to a reasonable number of these patients. The Donnelly bill would in essence codify the IRS's interpretation of the community benefit standard and add to it a charity care requirement. The administration reported it was opposed to a change from the current community benefit standard to an express charity care standard. Nevertheless, it would not oppose a more limited change that codifies the current position. Not-for-profit hospitals have opposed any changes, arguing that the existing community benefit standard is sufficient and that the decision of how to benefit the community should be made by an individual hospital and its community.
authors: Internal Revenue Service, Washington, DC.
authors: J J
authors: JJ
authors: McGovern
mesh_terms: D002608:Charities / Q000331:legislation & jurisprudence; D003159:Community-Institutional Relations / Q000191:economics / Q000331:legislation & jurisprudence*; D006077:Government Agencies; D006788:Hospitals, Voluntary / Q000191:economics / Q000331:legislation & jurisprudence* / Q000458:organization & administration; D008484:Medicaid / Q000331:legislation & jurisprudence; D008489:Medical Indigency / Q000331:legislation & jurisprudence; D006278:Medicare / Q000331:legislation & jurisprudence; D010360:Patient Transfer / Q000331:legislation & jurisprudence; D013660:Taxes / Q000331:legislation & jurisprudence*; D014481:United States