I
109th CONGRESS
2d Session
H. R. 6420
IN THE HOUSE OF REPRESENTATIVES
December 8, 2006
Mr. Thomas introduced the following bill; which was referred to the Committee on Ways and Means
A BILL
To amend the Internal Revenue Code of 1986 to impose an excise tax on certain medical care providers that fail to provide a minimum level of charity medical care, and for other purposes.
Short title
This Act may be cited as the Tax Exempt Hospitals Responsibility Act of 2006
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Required policies and procedures of specified medical care providers
In general
Section 501 of the Internal Revenue Code of 1986 (relating to exemption from tax on corporations, certain trusts, etc.) is amended—
by redesignating subsection (r) as subsection (s), and
by inserting after subsection (q) the following new subsection:
Policies and procedures of specified medical care providers
In general
A specified medical care provider shall not be treated as described in section 501(c)(3) unless such provider has adopted, and normally operates consistently with, policies and procedures for providing, and charging for, specified medically necessary care to low-income uninsured individuals consistent with the requirements of subchapter H of chapter 42.
Denial of deduction
No deduction shall be allowed under any provision of this title, including sections 170, 545(b)(2), 556(b)(2), 642(c), 2055, 2106(a)(2), and 2522, with respect to any contribution to an organization which is not described in section 501(c)(3) by reason of paragraph (1).
Definitions
Terms used in this subsection shall have the same meanings as when used in subchapter H of chapter 42, except that with respect to the term specified medical care provider
clause (i) of section 4968C(1)(A) shall not apply.
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Effective date
The amendments made by this section shall apply to taxable years beginning after December 31, 2007.
Failure by specified medical care provider to meet minimum charity care requirement
In general
Chapter 42 of the Internal Revenue Code of 1986 (relating to private foundations and certain other tax-exempt organizations) is amended by adding at the end the following new subchapter:
Failure by specified medical care provider To meet minimum charity care requirements
Sec. 4968. Excise tax on specified medical care provider for failure to provide specified medically necessary care.
Sec. 4968A. Excise tax on specified medical care provider for overcharging for specified medically necessary care.
Sec. 4968B. Excise tax on specified medical care provider for failure to disclose charitable medical care information and negotiated charges.
Sec. 4968C. Definitions.
Excise tax on specified medical care provider for failure to provide specified medically necessary care
If a specified medical care provider fails to provide specified medically necessary care to a low-income uninsured individual who seeks such care from such provider in an in-person visit, there is hereby imposed on such provider a tax equal to $1,000 for each such failure.
Excise tax on specified medical care provider for overcharging for specified medically necessary care
Imposition of tax
If a specified medical care provider collects from a low-income uninsured individual an amount in excess of the maximum allowed charges for specified medically necessary care provided to such individual, there is hereby imposed a tax on such provider in an amount equal to 3 times such excess.
Maximum allowed charges
For purposes of this section, the term maximum allowed charges
means—
with respect to a low-income uninsured individual whose annual household income is not more than 100 percent of the poverty line applicable to the size of the family involved, $25 for each visit, and
with respect to a low-income uninsured individual whose annual household income is more than 100 percent, but not more than 200 percent, of the poverty line applicable to the size of the family involved, the average amount paid to the specified medical care provider for such medical care under contracts with private health insurers.
Excise tax on specified medical care provider for failure to disclose charitable medical care information and negotiated charges
Imposition of tax
If a specified medical care provider fails to meet the requirements of subsection (b), there is hereby imposed a tax on such provider equal to $1,000—
for each such failure with respect to a requirement described in subsection (b)(1), and
for each day on which such failure occurred with respect to a requirement described in subsection (b)(2).
Disclosure of charitable medical care information and medical care price data
Disclosure to patients
The requirements of this paragraph are met if the specified medical care provider discloses its policies with respect to providing, and charging for, specified medically necessary care—
in the patient admission process, and
in any attempt by the provider to charge for medical care provided, and
Disclosure to public
The requirements of this paragraph are met if the specified medical care provider makes available to the public—
its policies with respect to providing, and charging for, specified medically necessary care, and
a list of the average prices actually paid to the provider for each procedure or service, grouped by private health insurance, self-pay, and governmental health programs.
Maximum tax
The amount of tax imposed under subsection (a)(2) with respect to each failure shall not exceed $50,000.
Definitions
For purposes of this subchapter—
Specified medical care provider
In general
The term specified medical care provider
means an organization which—
is described in section 501(c)(3),
has as its principal purpose the provision of medical or hospital care,
has as its principal purpose the provision of medical education or medical research and is actively engaged in providing medical or hospital care, or
is required under State law to be licensed as a hospital.
Exceptions
Such term shall not include a convalescent home or a home for children or the aged.
Specified medically necessary care
In general
The term specified medically necessary care
means any medical care which is within the scope of medical care provided by the specified medical care provider.
Exceptions
Such term shall not include—
any medical care—
which is attested to by the physician or practitioner treating the low-income uninsured individual as being not medically necessary, or
with respect to which the low-income uninsured individual signs a waiver acknowledging such care is not medically necessary, and
any organ transplant, any medical care that is cosmetic or experimental in nature, and any treatment to improve the functioning of a malformed member.
Low-income uninsured individual
In general
The term low-income uninsured individual
means any individual who, at the time the medical care is sought—
is not covered by insurance constituting medical care, other than coverage described in section 223(c)(1)(B),
has an annual household income equal to not more than 200 percent of the poverty line applicable to the size of the family involved,
does not fail the resource requirement of subparagraph (D) or (E) of section 1860–14(a)(3) of the Social Security Act,
is a citizen or resident of the United States, and
is not eligible for government-sponsored insurance constituting medical care.
Exception
An individual shall not be a low-income uninsured individual if the individual fails to comply with reasonable requests by a specified medical care provider to provide documentation, or make an attestation, regarding income, assets, citizenship or residency, or insurance status.
Poverty line
The term poverty line
has the meaning given such term in section 673 of the Community Services Block Grant Act (42 U.S.C. 9902).
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Conforming amendment
The table of subchapters for chapter 42 of such Code is amended by adding at the end the following new item:
Subchapter H. Failure by specified medical care provider to meet minimum charity care requirement.
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Effective date
The amendments made by this section shall apply to taxable years beginning after December 31, 2007.