Tax Exempt Hospital Transparency Act

This bill would require tax-exempt hospital organizations to provide more detailed financial and operational information to the Internal Revenue Service, including audited financial statements and specific data on financial assistance applications. Hospitals would also be required to report how they are addressing community health needs and explain why certain identified needs are not being met. Additionally, the Government Accountability Office would be tasked with studying the costs of these new reporting requirements and estimating the potential tax revenue from the nation's highest-earning non-profit hospitals if they were not tax-exempt.

This bill primarily affects tax-exempt hospital organizations that are required to conduct community health needs assessments and file IRS Form 990, particularly large or high-revenue institutions subject to additional reporting. The Internal Revenue Service is affected by the requirement to collect expanded financial and operational data, while the Government Accountability Office is tasked with conducting studies on reporting costs and potential tax revenue. Additionally, the legislation impacts hospital administrators responsible for reporting financial assistance application data and audited financial statements.

• Expanded IRS reporting for tax-exempt hospitals. Requires tax-exempt hospital organizations to include additional data with their annual Form 990 filings, such as audited financial statements and the cost-value of financial assistance provided.
• Community health needs assessment disclosures. Mandates that hospitals describe how they are addressing needs identified in their most recent assessment, including explanations for any identified needs that remain unaddressed.
• Financial assistance application tracking. Obligates hospitals to report the specific number of completed financial assistance applications received, approved, and denied during the tax year.
• Enhanced requirements for large hospital organizations. Imposes further information reporting requirements specifically targeting tax-exempt hospital organizations characterized by large size or high revenue.
• GAO study on compliance costs and tax revenue. Directs the Government Accountability Office to study the costs of these new reporting requirements and estimate potential tax revenue from the 25 highest-grossing tax-exempt hospitals if they were not exempt.

This bill expands reporting requirements for tax-exempt hospital organizations that are currently required to file IRS Form 990 and conduct community health needs assessments under existing federal tax law. It specifically adds new disclosure obligations regarding financial assistance policies and community health strategies to the established regulatory framework for these non-profit entities.

The bill aims to increase transparency and oversight of tax-exempt hospital organizations by requiring them to report detailed information regarding their community health needs assessments, financial assistance policies, and audited financial statements to the Internal Revenue Service. Additionally, it seeks to evaluate the fiscal impact of these reporting requirements and estimate potential tax revenue from high-revenue hospitals if their tax-exempt status were removed.