Hospital executives, representatives from trade and consumer groups and other health-policy shapers told the Senate Finance Committees ranking member Sen. Chuck Grassley (R-Iowa) and committee staffers that a draft report meant to better define what constitutes not-for-profit community benefit, while good in theory, nevertheless needs more work before putting its principles into practice.
Committee staff convened the roundtable discussion as a way to better shape potential legislation that would offer a more direct road map that tax-exempt hospitals would need to follow in order to receive the favored tax status.
But just what constitutes a community benefit and whether or not bad debt and federal underpayments should factor into the overall equation dominated the discussion.
John Colombo, a professor at the University of Illinois College of Law in Champaign-Urbana, said that tax-exempt hospitals should focus on the services they provideand to whomthat the for-profits dont. Hospitals should not get an exemption by claiming they do good things for society, he said.
In data released last week, the American Hospital Association showed that hospitals provided more than $31 billion in uncompensated care and nearly $30 billion more to cover costs that Medicare and Medicaid did not cover. In addition, many hospitals support services for the community that they must subsidize, such as mental-health services, geriatrics, chronic-disease management, inner-city and rural primary-care clinics and many others, said Nicholas Wolter, chief executive of the Billings (Mont.) Clinic and an AHA representative.
Grassley said he is still undecided whether he would introduce reform legislation this session. -- by Matthew DoBias
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