H.R. 3019 tightens requirements for nonprofit hospitals that receive federal tax exemptions, effective for tax years beginning after December 31, 2025. The bill requires tax-exempt hospitals to maintain community boards, serve Medicare and Medicaid patients without limiting their numbers, and spend money equal to the value of their tax exemptions on community benefits such as training, research, facility improvements, or free/discounted care—with facility improvements capped at 50 percent of this spending requirement. Nonprofit hospitals must also clearly offer financial assistance at Medicare rates to patients who qualify. The legislation directs the Treasury Inspector General to annually review hospital financial assistance policies and their compliance, while the Comptroller General must review IRS enforcement of these standards every three years and report findings to Congress. These changes aim to ensure that nonprofit hospitals receiving significant tax breaks provide meaningful community health benefits in return.
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