Tax Exempt Hospital Transparency Act

This bill amends the Internal Revenue Code to impose new information reporting obligations on tax-exempt hospital organizations. All such organizations would be required to disclose how they address community health needs, including any unaddressed needs and reasons why. They must also report audited financial statements, their Centers for Medicare & Medicaid Services (CMS) certification number, the value of financial assistance provided, and the number of financial assistance applications received, granted, and denied. For large and high-revenue hospitals, much of this information must be reported separately for each facility. Large tax-exempt hospital organizations, defined as those with over 100 staffed inpatient beds and not critical access or rural emergency hospitals, would face additional reporting. They must identify their top three priority health needs, detail spending on programs addressing these needs, and describe actions taken and their impact. Furthermore, these hospitals must report spending on quality improvement and nonclinical programming , which includes administrative support, information technology, billing, lobbying, and patient experience initiatives. This detailed reporting also applies separately to each hospital facility. High-revenue tax-exempt hospital organizations, those with over $100 million in net patient revenue, would have even more extensive requirements. They must report specified advertising costs, both allowable and unallowable, as reported to CMS. A significant provision requires detailed reporting on each health service line , including descriptions, gross receipts, and costs, with the Secretary of Health and Human Services developing a standardized taxonomy for this purpose. These high-revenue organizations must also provide specific information regarding their participation in the Federal 340B drug discount program. This includes the number of individuals receiving 340B drugs by insurance type, the aggregate net 340B payment amount, and the costs incurred for program participation and compliance. Finally, the bill mandates a Government Accountability Office (GAO) report to assess the administrative and compliance costs of these new requirements and estimate the potential tax liability if the highest-grossing tax-exempt hospitals were not exempt.