YourVoice.Now Summary
Transparency & AccountabilityHospitals that pay no income tax would report what free care costs them, and how many aid requests they turn down.
Transparency & Accountability
Nonprofit hospitals give free or low-cost care to patients who cannot pay. Each would list the yearly cost of that care on its Form 990, a public tax filing.
Hospitals would report how many people asked for help paying, how many got it, and how many did not. Smaller hospitals start with tax years more than three years after the law passes.
A system with several hospitals would report each one on its own, not as one big total. This covers hospitals over 100 beds, plus those taking in over $100 million from patients.
Hospitals already survey their community's health needs every few years. Those with more than 100 staffed beds would name the top three needs, report what they spent on each, and describe what changed as a result.
One total would cover office work: admin, IT, hiring, billing, and lobbying. A second would cover work meant to make patients healthier.
These hospitals would report what each kind of care earns and what it costs. Health officials must first publish a standard list of care types, due within two years of the law.
The federal 340B program lets some hospitals buy drugs at a discount. They would report how much they collected above that price, how many patients got the drugs, and what the program costs to run.
Three years after the law passes, a government watchdog would start a study. It would price the new paperwork and the tax the 25 biggest nonprofit hospital groups would owe if taxed.
Two kinds of rural hospitals are left out at any size: critical access and rural emergency. Those with 100 or fewer beds skip the extra forms too, unless patients bring in over $100 million.
More about this bill
Nothing here changes what you pay at a nonprofit hospital. What changes is what the public gets to see. Nonprofit hospitals pay no federal income tax. In return, they are expected to serve their communities. New rules would make them show that work in numbers each year. Every tax-exempt hospital would report the yearly cost of the financial help it gives patients. It would also report how many patients asked for that help. It would report how many were turned down. Hospitals with more than 100 beds would report more. They would name their top three community health needs and what they spent on each. They would also report one total for back-office work, such as billing, admin, and lobbying. Big hospital systems could no longer lump all their sites into one number. Small and rural hospitals would file only the basic numbers. Hospitals with more than $100 million in patient revenue would report the most. They would break out revenue and costs for each type of care they give. They would report what they spend on ads. Some of them buy drugs at a federal discount, called 340B. They would report how much they keep above that discount price. A government watchdog would also estimate what the 25 largest hospital groups would owe in tax without the exemption. None of this changes the rules for staying tax-exempt. The first reports would not arrive for about three years.
Congressional Summary
Tax Exempt Hospital Transparency ActThis bill requires tax-exempt hospital organizations to report additional information to the Internal Revenue Service.The bill defines a tax-exempt hospital organization as an organization that is licensed or recognized as a hospital and is required toconduct a community health needs assessment and adopt a strategy to meet the needs identified in the assessment,have a written financial assistance policy,limit charges for emergency and medically necessary care provided to individuals eligible for financial assistance and prohibit the use of gross charges,meet certain billing and collection requirements, andfile IRS Form 990 (Return of Organization Exempt From Income Tax).Under the bill, a tax-exempt hospital organization must include with Form 990 certain identifying information anda description of how the organization addresses the needs identified in the most recent community health needs assessment, the needs not addressed, and the reasons why needs are not being addressed;audited financial statements;the value (at cost) of the financial assistance provided; andthe numbers of completed financial assistance applications received, granted, and denied during the tax year.Further information reporting requirements are imposed on certain large or high-revenue tax-exempt hospital organizations.Finally, the bill requires the Government Accountability Office to (1) study and report the costs associated with the additional information reporting requirements, and (2) estimate the amount of tax revenue that would be generated from the 25 tax-exempt hospital organizations with the highest gross revenue if such organizations were not exempt from tax.
Details
- Congress
- 119th
- Chamber
- House
- Status
- summarized
- Action
- Introduced in House
- Action Date
- 2026-06-29
- Date Added
- 2026-07-21
- Source
- Congress.gov →
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