New rules set forth by the U.S. Department of Treasury and the Internal Revenue Service are placing tougher demands on tax-exempt hospitals to ensure protection of patient rights. The rules clarify and facilitate implementation of regulations already in place under the Affordable Care Act (ACA) that mandate charitable hospitals provide guidance on patient protections and help improve the health of communities.
The new laws require that charitable hospitals ensure transparency in their billing and collection policies. At the heart of this transparency is the protection of patients’ rights by the mandate that these hospitals limit charges to patients eligible for financial assistance, establish and disclose financial assistance policies, and abide by reasonable billing and collection requirements.
A further mandate is the requirement that charitable hospitals conduct and publish a community health needs assessment at least once every three years, which would describe how significant community health needs will be addressed. To do this, hospitals need to solicit input from the community, with particular focus on vulnerable populations. Hospitals that fail to comply could be fined $50,000 and/or have their tax exempt status revoked.
In a blog published May 12 at communitycatalyst.org, Michele Craig, an outreach and training coordinator for the Hospital Accountability Project, a project with Community Catalyst (a consumer health advocacy group) that has been tracking the developments of the implementation of these rules in tax exempt hospitals across the nation, said that a number of loopholes still remain in enforcing the financial assistance/charity care mandated by the rules. She also highlighted the challenge of forming the needed partnerships between the community and charitable hospitals.
“Finding common language and bridging cultures can be challenging for both the hospital and the community, as community members struggle to find the resources necessary to engage in the community benefit work and as hospital staff navigate institutional barriers and begin to appreciate the benefits of these partnerships,” she writes.
To facilitate these partnerships, she referred to a fact sheet compiled by her organization [PDF] that, among other things, provides examples of hospital programs that improve community health and access.