On June 22, the Department of the Treasury and Internal Revenue Service (IRS) released long-anticipated proposed regulations implementing three of the four new requirements created by the Patient Protection and Affordable Care Act (ACA) for tax-exempt hospitals:
- adoption of a written financial assistance policy and a policy relating to emergency medical care;
- limitations on the amounts a hospital charges to individuals eligible for financial assistance for emergency or other medically necessary care; and
- limits on engaging in extraordinary collection actions before making reasonable efforts to determine an individual's eligibility for financial assistance.
The new requirements are found in Section 501(r) of the Internal Revenue Code. The proposed regulation does not address the ACA requirement that a community health needs assessment (CHNA) be conducted every three years.
IRS has asked for comments on its estimate of burden for compliance with the requirements imposed by the proposed regulation. Please use the American Hospital Association's model comment letter to help draft your comments on the burden created by the "collection of information" required by the proposed Treasury regulations.
Under the Paperwork Reduction Act, the Office of Management and Budget (OMB) must approve any requirement involving the collection of information and the public must have an opportunity to comment on the burden; therefore, IRS asks that concerned parties direct their comments to OMB. In addition to the model letter, the AHA has created a worksheet (attached below) that walks through the relevant provisions to assist you in calculating hourly estimates for a hospital's compliance with the proposed regulations.
The deadline for comments on the proposed collection requirements and the associated burden is Aug. 27. Comments can be submitted at the following address:
Office of Management and Budget
Attn: Desk Officer for the Department of the Treasury
Office of Information and Regulatory Affairs
Washington, DC 20503
Please also send a copy of your comments to the AHA at vdemetrius@aha.org. Watch for a model comment letter to the Department of the Treasury and IRS on the overall proposed regulations at the end of August. Those comments are due Sept. 24.

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