U.S. Health Care Reform Update
President Obama on March 30 signed the Health Care and Education Reconciliation Act (H.R. 4872) which makes adjustments to the Patient Protection and Affordable Care Act (H.R. 3590) signed by the President on March 23. The reconciliation measure contains a few technical modifications to the originally passed health reform bill, but made no changes to the new requirements of nonprofit hospitals included in H.R. 3590.
The following outlines the provisions included in the final legislation that affect health care philanthropy:
- Community Needs Assessment Requirement. To be performed at least once every three years with input from the community and the assistance of individuals with special knowledge or expertise of public health issues, and to be widely publicized. An implementation strategy must be adopted to meet the community needs outlined in the assessment. The assessment may be conducted in conjunction with other organizations. Failure to complete an assessment would result in a penalty of up to $50,000. (H.R.3590, § 9007)
- Promotion of a Financial Assistance Policy. Creation and implementation of a policy to widely publicize the health care organization's financial assistance policy and how to apply for assistance. The policy must also prevent discrimination against those eligible for financial assistance who seek emergency treatment. (H.R.3590, § 9007)
- Limitation on Charges. Limitation on billing patients who qualify for financial assistance to no more than the amount generally billed to insured patients.
- Limitation on Collection. Limitation on taking extraordinaty collection actions against patients without first making attempts to inform the patient about the health care organization's financial assistance policy.
- Community Benefit Review. To be perfomed by the IRS at least once every three years based on information provided in IRS Form 990. (H.R.3590, § 3014)
- HHS Annual Report to Congress. To report levels of charity care, bad debt expenses, unreimbursed costs of means-tested and non-means tested government programs and the cost of community benefit activities. In addition, HHS will conduct a trends study for these areas within five years to be reported to Congress. (H.R., 3590, § 3959)
The bill does NOT include limitations on the tax deductibility of charitable gifts. For more information, including the full text of the bills, an outline of the differences between the two bills and a more comprehensive overview of the likely impact of the bill on health care philanthropy, please see the items to the right listed under "Also of Interest."