Volume 26.02
On May 12, 2026, a Congressional discussion draft (“Draft”) was released that would significantly expand Form 990 reporting by tax-exempt hospitals. The draft would apply to all organizations described in IRS Code Section 501(r)(2). Section 501(r) is a set of rules under the Affordable Care Act (“ACA”) that requires tax-exempt, charitable hospitals to meet specific conditions to maintain their 501(c)(3) tax-exempt status. The discussion draft is available here. This is a direct follow-up of a release by the Congressional Research Group on March 30, 2026, available here.
The following, based on the Draft, would require the following to be reported:
1. Spending by the hospital, in the aggregate and seperately, for each hospital facility:
a. Community benefits,
b. Charity care,
c. Advertising,
d. Quality improvement, and
e. Nonclinical programming.
2. The tax that would apply if the organization were not tax exempt.
3. A description of each subsidized health service line, plus revenue generated and cost of each as reported to CMS.
4. The top three highest-priority community health needs and spending on programs addressing each.
5. The number of financial assistance applications received, granted, and denied under the hospital’s financial assistance policy. Under Section 5010(r)(4), hospitals are required to establish a written financial assistance policy and a written emergency care policy for any hospital facility it operates, stated h
6. The number of individuals dispensed 340B covered outpatient drugs, and the aggregate net revenue less aggregate participation/
Many items are currently undefined, such as charity care, advertising, quality improvement, nonclinical programming, and health service line. This is a draft and substantial revision would be expected prior to any final consideration. If enacted in this or other form, the requirements are currently scheduled to be effective six months after enactment.
We encourage tax-exempt hospitals to get familiar with the Draft, and give consideration to the ability and resources required to provide that information required by the Draft. Additionally, hospitals should ensure that those external consultants that prepare their Form 990 are aware of the Draft.
REGISTRATIONS BEING ACCEPTED FOR HOSPICE FINANCIAL AND COMPLIANCE PROGRAM
The 2026 “Hospice Financial & Compliance Management Conference” is now available to register. The two-day program is being held at Paris Las Vegas on October 1-2, 2026.
As always, this program offers the most extensive hospice financial coverage available. The integration of finance and compliance is critical to survival and success of any hospice. This year compliance and the associated financial risks are critical. Initial information and registration information is available here. Discounted room rates are available here or by calling (877) 603-4389. Make certain to inform Paris Las Vegas that you are attending The Health Group program. See you in Las Vegas.