Advocacy and Public Policy

• Patient Protection and Affordable Care Act legislation  — see sections 4959, 9007 and 10903 for new requirements for tax-exempt hospitals. (.pdf)
• Summary of Provisions Related to Tax Exempt Hospitals in Health Reform Law, March 31, 2010 (.pdf)
• Understanding the Federal Community Benefit Standard
• Revenue Ruling 69-545 (.pdf)
• Revenue Ruling 83-157 (.pdf)
• Community Catalyst, Free Care Compendium — summary of the free care laws and regulations in each of the fifty states
• Comparison of CHA's Guide for Planning and Evaluating Community Benefit and state laws (as of August 2010 — revised) (.pdf)
• State Hospital Associations — Voluntary Community Benefit Reporting (as of August 2010) (.pdf)
• Survey of State Laws/Oversight related to Community Health Needs Assessments and Implementation Strategies (as of August 2010) (.pdf)

Regulatory and Congressional Actions/Reports

• IRS Nonprofit Hospital Study — Final Report (Feb. 12, 2009)
• GAO Report on Comparison of Community Benefit Requirements, September 2008 (.pdf)
• Revised 990 Form
  • Revised 990 core form (.pdf)
  • Schedule H (.pdf)
  • Instructions for Form 990
  • Schedule H Instructions and Worksheets (.pdf)

CHA Communications

• 9/22/11 — IRS Notice and Request for Comments Regarding the Community Health Needs Assessment Requirements for Tax-exempt Hospitals.
• IRS Notice 2011-52
• CHA Comments
• 7/22/10 — IRS Request for Comments Regarding Additional Requirements for Tax-Exempt Hospitals
  • IRS Notice 2010-39 (.pdf)
  • CHA Comments on Requirements for Tax-Exempt Hospitals (.pdf)
• 9/13/06 — Senate Finance Committee Hearing — this page contains several documents related to this hearing including a transcript of Sr. Carol Keehan's testimony, opening remarks from Senators Baucus and Grassley and a report from the Joint Committee on Taxation.
• 9/12/07 — CHA Submits Comments on Form 990 Proposed Revisions (.pdf)
• 4/13/06 — CHA Response to Chairman Grassley's Request for Information (.pdf)
• 5/26/05 — Sr. Carol Keehan Testimony (.pdf)

Other Reports/Research/Articles

• Beyond Charity Care: Mission Matters for Tax-Exempt Health Care, J. David Seay, Esquire, The Catholic Health Association, 2007
• What Have You Done for Me Lately? Assessing Hospital Community Benefit, Issue Brief from the National Health Policy Forum, April 2007
• Community Benefit Information from Non-Profit Hospitals: Lessons Learned From the 2006 IRS Compliance Check Questionnaire, A Report Prepared for the American Hospital Association by Ernest and Young, November 2006 (.pdf)
• Why Nonprofits Matter in American Medicine: A Policy Brief, Nonprofit Sector Research Fund: Working Paper Series, 2005 (.pdf)

Other Resources for Advocacy Leaders

• CHA's Advocacy website