Tax Exempt Hospitals Responsibility Act of 2006 - Amends the Internal Revenue Code to: (1) deny a tax exemption to medical care providers (i.e., tax-exempt charitable or teaching hospitals) that fail to adopt and carry out policies for providing medically necessary care to low-income individuals without health insurance; (2) deny a tax deduction for contributions to such providers; and (3) impose excise tax penalties on such medical care providers for failing to provide medically necessary care to low-income uninsured individuals, for overcharging for such care, and for failing to make certain disclosures to patients and the public relating to medical care and pricing.
[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6420 Introduced in House (IH)]
109th CONGRESS
2d Session
H. R. 6420
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.
_______________________________________________________________________
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.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Tax Exempt Hospitals Responsibility
Act of 2006''.
SEC. 2. REQUIRED POLICIES AND PROCEDURES OF SPECIFIED MEDICAL CARE
PROVIDERS.
(a) In General.--Section 501 of the Internal Revenue Code of 1986
(relating to exemption from tax on corporations, certain trusts, etc.)
is amended--
(1) by redesignating subsection (r) as subsection (s), and
(2) by inserting after subsection (q) the following new
subsection:
``(r) Policies and Procedures of Specified Medical Care
Providers.--
``(1) 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.
``(2) 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).
``(3) 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.''.
(b) Effective Date.--The amendments made by this section shall
apply to taxable years beginning after December 31, 2007.
SEC. 3. FAILURE BY SPECIFIED MEDICAL CARE PROVIDER TO MEET MINIMUM
CHARITY CARE REQUIREMENT.
(a) 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:
``Subchapter H--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.
``SEC. 4968. 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.
``SEC. 4968A. EXCISE TAX ON SPECIFIED MEDICAL CARE PROVIDER FOR
OVERCHARGING FOR SPECIFIED MEDICALLY NECESSARY CARE.
``(a) 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.
``(b) Maximum Allowed Charges.--For purposes of this section, the
term `maximum allowed charges' means--
``(1) 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
``(2) 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.
``SEC. 4968B. EXCISE TAX ON SPECIFIED MEDICAL CARE PROVIDER FOR FAILURE
TO DISCLOSE CHARITABLE MEDICAL CARE INFORMATION AND
NEGOTIATED CHARGES.
``(a) 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--
``(1) for each such failure with respect to a requirement
described in subsection (b)(1), and
``(2) for each day on which such failure occurred with
respect to a requirement described in subsection (b)(2).
``(b) Disclosure of Charitable Medical Care Information and Medical
Care Price Data.--
``(1) 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--
``(A) in the patient admission process, and
``(B) in any attempt by the provider to charge for
medical care provided, and
``(2) Disclosure to public.--The requirements of this
paragraph are met if the specified medical care provider makes
available to the public--
``(A) its policies with respect to providing, and
charging for, specified medically necessary care, and
``(B) 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.
``(c) Maximum Tax.--The amount of tax imposed under subsection
(a)(2) with respect to each failure shall not exceed $50,000.
``SEC. 4968C. DEFINITIONS.
``For purposes of this subchapter--
``(1) Specified medical care provider.--
``(A) In general.--The term `specified medical care
provider' means an organization which--
``(i) is described in section 501(c)(3),
``(ii) has as its principal purpose the
provision of medical or hospital care,
``(iii) has as its principal purpose the
provision of medical education or medical
research and is actively engaged in providing
medical or hospital care, or
``(iv) is required under State law to be
licensed as a hospital.
``(B) Exceptions.--Such term shall not include a
convalescent home or a home for children or the aged.
``(2) Specified medically necessary care.--
``(A) 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.
``(B) Exceptions.--Such term shall not include--
``(i) any medical care--
``(I) which is attested to by the
physician or practitioner treating the
low-income uninsured individual as
being not medically necessary, or
``(II) with respect to which the
low-income uninsured individual signs a
waiver acknowledging such care is not
medically necessary, and
``(ii) any organ transplant, any medical
care that is cosmetic or experimental in
nature, and any treatment to improve the
functioning of a malformed member.
``(3) Low-income uninsured individual.--
``(A) In general.--The term `low-income uninsured
individual' means any individual who, at the time the
medical care is sought--
``(i) is not covered by insurance
constituting medical care, other than coverage
described in section 223(c)(1)(B),
``(ii) has an annual household income equal
to not more than 200 percent of the poverty
line applicable to the size of the family
involved,
``(iii) does not fail the resource
requirement of subparagraph (D) or (E) of
section 1860-14(a)(3) of the Social Security
Act,
``(iv) is a citizen or resident of the
United States, and
``(v) is not eligible for government-
sponsored insurance constituting medical care.
``(B) 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.
``(4) 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).''.
(b) 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.''.
(c) Effective Date.--The amendments made by this section shall
apply to taxable years beginning after December 31, 2007.
<all>
Introduced in House
Introduced in House
Referred to the House Committee on Ways and Means.
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