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Senate Hearings on Community Benefits and Federal Oversight of Not-For-Profits |
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The September 18, 2006 issue of Modern Healthcare included an article concerning Senate hearings held in September 2006 on community benefits standards and federal oversight of not-for-profits. The article reported that, under the threat of legislation, and at the strong urging of Finance Committee Chairman Sen. Chuck Grassley, the healthcare industry and Finance committee staff are formulating recommendations for getting the not-for-profit hospital sector on a common track in both reporting and providing charity care and benefits to the communities it serves. Sen. Grassley suggested that the charity care guidelines developed by the Catholic Health Association (CHA) in alliance with the VHA, can serve as a “starting point”. Most of the hospitals in the VHA and CHA have already agreed to abide by those recommendations. The guidelines count charity care and Medicaid payments shortfalls based on costs, not charges, as community benefits. They do not count bad debts or Medicare underpayments. Grassley also noted that there were “enormous differences” in responses to not-for-profit healthcare systems that were surveyed in 2005, make comparisons between responses impossible. Grassley also focused on executive compensation and was especially critical of the payment of senior executives’ country club dues by some healthcare organizations, even as those organizations defended those payments as a necessary business expense. Grassley also stated that the IRS is developing a supplemental report to the Form 990 to include additional information form not-for-profit hospitals about their charity care and community benefits and said he hoped that the IRS would consider having that information conform to the CHA guidelines. The American Hospital Association (AHA) also supports attaching a community benefit report to the 990. The AHA also recommends that CEO personally sign off on their organizations’ 990 forms. Grassley also directed Finance Committee staff to develop a discussion paper with a draft ready for public comment within a few weeks. From there, he said he would like “interested and knowledgeable parties” to weigh in as proposals are considered. |