March 28, 2024

Congress Asks I.R.S. About Oversight of Nonprofit Hospitals

Those hospitals, however, remain exempt from federal taxes — a far bigger benefit — because the Internal Revenue Service is not collecting information to assess the extent of the care for poor and uninsured patients that nonprofit hospitals nationwide are supposed to provide. In September, the governor of Illinois suspended the revocation pending legislation that set more definitive guidelines.

An overhauled tax form for nonprofits would give the federal tax agency that data, but complaints from the American Hospital Association and aspects of the new health care law have prompted the I.R.S. to delay requiring hospitals to fill out the portion of the form on charity care. Hospitals may not have to fill it out this year, either, because the agency has yet to make a decision.

Jessica Curtis, project director for the hospital accountability project of Community Catalyst, a consumer advocacy group, said she could not understand why the I.R.S. had not enforced the reporting requirement. The new schedule “asks a good set of questions that are pretty straightforward and easy to answer,” Ms. Curtis said. “Many of them are questions most major hospitals have already been voluntarily answering, anyway.”

She said regulators might not understand the impact such disclosure had on poor patients and their advocates. “In the current environment, more and more patients are trying to figure out what’s available to them, and this schedule would help,” she said.

Sarah Hall Ingram, commissioner of the Tax Exempt and Government Entities Division of the I.R.S., said the new federal health care legislation, not hospital complaints, had influenced the agency’s decision to reconsider the requirement.

Now, Congress has started asking questions about the reporting required of nonprofit hospitals — and a wide range of other issues around the tax agency’s oversight of charities. Last month, Charles W. Boustany Jr., Republican of Louisiana and a member of the House Ways and Means Committee, sent the I.R.S. a letter seeking an explanation of how it conducted nonprofit oversight and what it was doing to tighten compliance with the laws and regulations governing charity and philanthropy.

In particular, Mr. Boustany asked the I.R.S. to explain its plans for monitoring the so-called community benefits that nonprofit hospitals provided. He also wanted the agency to outline how it would comply with requirements for filing annual reports to Congress on the charity care provided by all hospitals.

In the letter, Mr. Boustany, who is chairman of the Ways and Means subcommittee on oversight, wrote that panel members were concerned that “tax exempt organizations may not be complying with the letter or the spirit of the tax-exempt regime, yet continue to enjoy the benefits of tax exemption.”

In a subsequent telephone interview, Mr. Boustany said: “We need to get a general sense of what’s going on in this whole sector of the economy. Ways and Means hasn’t looked at it for some time, and I’m really trying to take the role of oversight very seriously.”

In the last decade, Senator Charles E. Grassley, Republican of Iowa, and Bill Thomas, the former chairman of the House Ways and Means Committee, were the most aggressive among lawmakers trying to exert control over the nonprofit sector. “There is strong bipartisan interest,” Mr. Boustany said, in having Congress be more active in supervising these organizations.

A number of lawyers, accountants and state regulators say Congressional attention is long overdue. They have expressed frustration with what they regard as the I.R.S.’s failure to police nonprofits, which come to life at the rate of roughly one every 10 minutes.

Article source: http://feeds.nytimes.com/click.phdo?i=f5b3a4f8ec547eed05eafaa2b71ab7a3