The Catholic Health Association last week joined the American Hospital Association in a plea for broader criteria from the Internal Revenue Service as to what constitutes community benefitsthough the AHA would go farther than its Catholic counterpart.
The request from the St. Louis-based Catholic trade group came in a letter submitted to the IRS shortly before a 90-day public comment period closed on Sept. 14. Tax officials unveiled in June a plan to set nationwide standards for reporting how much hospitals spend on community aid in exchange for tax breaks as part of an overhaul of its yearly reporting rules for tax-exempt organizations (June 18, p. 8). Comments filed prior to the deadline and posted online since mid-August include letters from at least 97 hospitals, the American Hospital Association and the industrys state-level trade groups.
Tax officials failed to go far enough when setting criteria for what hospitals may claim as community benefits, CHA and AHA officials contend, and both would like to see so-called community building added to the criteria. Hospital costs not directly tied to careinvestments to improve housing, education, the environment or economic developmentboost wellness and should therefore be recognized as subsidized aid, both associations argue.
And the pair has also called for the IRS to drop questions on hospitals billing and collection efforts, which has been a point of contention in recent years after reports that uninsured patients were typically charged healthcares sticker price for services.
However, the CHA and AHA disagree on whether bad debt and Medicare losses should also be considered aid. The IRS left out the costs, a position the CHA endorsed. The AHA has urged the IRS to include them.
Medicare cannot be considered a community benefit because federal officials adjust Medicare payments regularly and an oversight body has not reported lack of access to care among the public programs enrollees, the CHA argued in its letter. Including such losses and bad debts, or bills not paid by patients who did not receive charity care, would jeopardize the credibility of community benefit reporting, the CHA wrote.
Lisa Gilden, CHA vice president and general counsel, said final instructions for any overhauled form arent expected until June 2008.
Separately, more than 20 groups, including Community Catalyst, Families USA and the Access Project, submitted a letter last week urging the IRS to move swiftly and bolster required reporting on hospitals policies for free and discounted care for low-income patients or charity care.
Susan Sherry, deputy director of the Boston-based Community Catalyst, called expanded charity-care policy disclosure and a uniform standard for how hospitals define and report aid they provide critical to boosting transparency. Those are pretty fundamental things from a community point of view and from a consumers perspective, she said, calling such information basic, basic stuff.