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<bill bill-stage="Introduced-in-House" dms-id="HB7B61E36277B4615B551BEC82FAE5DBE" public-private="public" bill-type="olc"> 
<metadata xmlns:dc="http://purl.org/dc/elements/1.1/">
<dublinCore>
<dc:title>109 HR 6420 IH: Tax Exempt Hospitals Responsibility Act of 2006</dc:title>
<dc:publisher>U.S. House of Representatives</dc:publisher>
<dc:date>2006-12-08</dc:date>
<dc:format>text/xml</dc:format>
<dc:language>EN</dc:language>
<dc:rights>Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.</dc:rights>
</dublinCore>
</metadata>
<form> 
<distribution-code display="yes">I</distribution-code> 
<congress>109th CONGRESS</congress> <session>2d Session</session> 
<legis-num>H. R. 6420</legis-num> 
<current-chamber>IN THE HOUSE OF REPRESENTATIVES</current-chamber> 
<action> 
<action-date date="20061208">December 8, 2006</action-date> 
<action-desc><sponsor name-id="T000188">Mr. Thomas</sponsor> introduced the following bill; which was referred to the <committee-name committee-id="HWM00">Committee on Ways and Means</committee-name></action-desc> 
</action> 
<legis-type>A BILL</legis-type> 
<official-title>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.</official-title> 
</form> 
<legis-body id="H4B52BB39E6E141879D3BEB1C1066D92E" style="OLC"> 
<section id="H32CEF6E7E5014625B9F54C03774C798D" section-type="section-one"><enum>1.</enum><header>Short title</header><text display-inline="no-display-inline">This Act may be cited as the <quote><short-title>Tax Exempt Hospitals Responsibility Act of 2006</short-title></quote>.</text></section> 
<section id="H858847D915AC4C2BBC4081E2B5CE168F"><enum>2.</enum><header> Required policies and procedures of specified medical care providers</header> 
<subsection id="H2598E1D2107B4AFAAA74DA73A273E37E"><enum>(a)</enum><header>In general</header><text><external-xref legal-doc="usc" parsable-cite="usc/26/501">Section 501</external-xref> of the Internal Revenue Code of 1986 (relating to exemption from tax on corporations, certain trusts, etc.) is amended—</text> 
<paragraph id="HD2B2C8E0BEA44DD4BC5235CE3102E55F"><enum>(1)</enum><text>by redesignating subsection (r) as subsection (s), and</text></paragraph> 
<paragraph id="HD7885BA62F9147EF8DA8DD2C653BC509"><enum>(2)</enum><text>by inserting after subsection (q) the following new subsection:</text> 
<quoted-block style="OLC" id="H1F4FEBA3D91E4DA9926182735823A9EA" display-inline="no-display-inline"> 
<subsection id="H2431EE4F1D6D4F479CE2A951838E664"><enum>(r)</enum><header>Policies and procedures of specified medical care providers</header> 
<paragraph id="HCF1C906E29D64630AAF07B2733C98F5"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">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.</text></paragraph> 
<paragraph id="H1D4AF6EB05B6499992C1F470BBD5331D"><enum>(2)</enum><header>Denial of deduction</header><text display-inline="yes-display-inline">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).</text> </paragraph> 
<paragraph id="H79235AA370FD429FA6D4282F3B9870EC"><enum>(3)</enum><header>Definitions</header><text>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 <quote>specified medical care provider</quote> clause (i) of section 4968C(1)(A) shall not apply.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection> 
<subsection id="H0D539298051A46E496361000FE1E0051"><enum>(b)</enum><header>Effective date</header><text>The amendments made by this section shall apply to taxable years beginning after December 31, 2007.</text></subsection></section> 
<section id="H15ED6FE0C3F8415592ABFDC4FF6A796"><enum>3.</enum><header>Failure by specified medical care provider to meet minimum charity care requirement</header> 
<subsection id="HFBE570E5ADE64C34B67D18E3E157D7C"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline"><external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/26/42">Chapter 42</external-xref> 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:</text> 
<quoted-block style="OLC" id="H5EA03EAB81F545AB95DC8910748979E9" display-inline="no-display-inline"> 
<subchapter id="HB67D75980F6C4A0A8200A1E887BAEBD7"><enum>H</enum><header>Failure by specified medical care provider To meet minimum charity care requirements</header> 
<toc regeneration="no-regeneration"> 
<toc-entry level="section">Sec. 4968. Excise tax on specified medical care provider for failure to provide specified medically necessary care.</toc-entry> 
<toc-entry level="section">Sec. 4968A. Excise tax on specified medical care provider for overcharging for specified medically necessary care.</toc-entry> 
<toc-entry level="section">Sec. 4968B. Excise tax on specified medical care provider for failure to disclose charitable medical care information and negotiated charges.</toc-entry> 
<toc-entry level="section">Sec. 4968C. Definitions.</toc-entry></toc> 
<section id="HFDDF7DF635B546DE9154A2F7A5D08645"><enum>4968.</enum><header>Excise tax on specified medical care provider for failure to provide specified medically necessary care</header> <text display-inline="no-display-inline">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. </text></section> 
<section id="H9EFB2118F3C145949F6F59D4F4DC3649"><enum>4968A.</enum><header>Excise tax on specified medical care provider for overcharging for specified medically necessary care</header> 
<subsection id="H48FF62EA8384464684397F07C7E6B800"><enum>(a)</enum><header>Imposition of tax</header><text>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.</text></subsection> 
<subsection id="H9CB0721EB59A416484A7A1FFBB724D3B"><enum>(b)</enum><header>Maximum allowed charges</header><text>For purposes of this section, the term <quote>maximum allowed charges</quote> means—</text> 
<paragraph id="HA36DB4825AE044718039C0630733C725"><enum>(1)</enum><text>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</text></paragraph> 
<paragraph id="H497422D69A2E4B5D9174830071DA9521"><enum>(2)</enum><text display-inline="yes-display-inline">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.</text></paragraph></subsection> </section> 
<section id="HA6A8933798044D0B9D42137B54CA4FFA"><enum>4968B.</enum><header>Excise tax on specified medical care provider for failure to disclose charitable medical care information and negotiated charges</header> 
<subsection id="H5983E0638ED945A2BF844D1EE046D679"><enum>(a)</enum><header>Imposition of tax</header><text>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—</text> 
<paragraph id="HA7EEDFAF20FC4668993C54B9C3509CDC"><enum>(1)</enum><text>for each such failure with respect to a requirement described in subsection (b)(1), and</text></paragraph> 
<paragraph id="H6146DDED15B844B28939C3B8B97EDAE5"><enum>(2)</enum><text>for each day on which such failure occurred with respect to a requirement described in subsection (b)(2).</text></paragraph></subsection> 
<subsection id="H957B7F126DC44FE99C7D22B82952AE14"><enum>(b)</enum><header>Disclosure of charitable medical care information and medical care price data</header> 
<paragraph id="H2C408111995844EEA300688BC1ADDE92"><enum>(1)</enum><header>Disclosure to patients</header><text>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—</text> 
<subparagraph id="H741C11BDA8EA4BB7988DF7ED4D20D600"><enum>(A)</enum><text>in the patient admission process, and</text></subparagraph> 
<subparagraph id="H2DF08F6EADE9432790B4EDED49EDB8CD"><enum>(B)</enum><text>in any attempt by the provider to charge for medical care provided, and </text></subparagraph></paragraph> 
<paragraph id="HED613BAD1A784787AE16DD047DC0219F"><enum>(2)</enum><header>Disclosure to public</header><text display-inline="yes-display-inline">The requirements of this paragraph are met if the specified medical care provider makes available to the public—</text> 
<subparagraph id="HBB54EAC9177B439B8750C209BA0813E0"><enum>(A)</enum><text display-inline="yes-display-inline">its policies with respect to providing, and charging for, specified medically necessary care, and</text></subparagraph> 
<subparagraph id="H9F6FE0C43E20498998F81FD08CB8F97E" commented="no"><enum>(B)</enum><text>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. </text></subparagraph></paragraph></subsection> 
<subsection id="HCFEEE57DBD5A4B8CB5B9A7DF887E131E"><enum>(c)</enum><header>Maximum tax</header><text>The amount of tax imposed under subsection (a)(2) with respect to each failure shall not exceed $50,000.</text></subsection> </section> 
<section id="HF9B535640C0D4D5AA33EA5309D39AED7"><enum>4968C.</enum><header>Definitions</header> <text display-inline="no-display-inline">For purposes of this subchapter—</text> 
<paragraph id="H477E7EB166CC4E2880CFC5D4C9F1DD07"><enum>(1)</enum><header>Specified medical care provider</header> 
<subparagraph id="H7C196FAE5F2B45D1B815F8E560087AD"><enum>(A)</enum><header>In general</header><text>The term <quote>specified medical care provider</quote> means an organization which—</text> 
<clause id="H2F1082F957CC41FCBC8D01BBB7EECA19"><enum>(i)</enum><text display-inline="yes-display-inline">is described in section 501(c)(3),</text> </clause> 
<clause id="H7A5BAB5C934840F9A26DA313A2DF7F36"><enum>(ii)</enum><text display-inline="yes-display-inline">has as its principal purpose the provision of medical or hospital care,</text></clause> 
<clause id="H6D09469C2F1747FA8B4F78C5DBAF5849"><enum>(iii)</enum><text>has as its principal purpose the provision of medical education or medical research and is actively engaged in providing medical or hospital care, or</text></clause> 
<clause id="HED381B2068ED4A9EBBD0143100E1AC28"><enum>(iv)</enum><text>is required under State law to be licensed as a hospital.</text></clause></subparagraph> 
<subparagraph id="H51E133D5997B4BD0ACE86D9B3D728709"><enum>(B)</enum><header>Exceptions</header><text>Such term shall not include a convalescent home or a home for children or the aged.</text></subparagraph></paragraph> 
<paragraph id="HA3E53E07BE3341AAA7EC88F0D00A152"><enum>(2)</enum><header>Specified medically necessary care</header> 
<subparagraph id="H1B9DA1F8849A41779688A14387DA6D4E"><enum>(A)</enum><header>In general</header><text>The term <quote>specified medically necessary care</quote> means any medical care which is within the scope of medical care provided by the specified medical care provider.</text> </subparagraph> 
<subparagraph id="HD40267FA068D4036B9E5D1681D1EC3DC"><enum>(B)</enum><header>Exceptions</header><text>Such term shall not include—</text> 
<clause id="HF4C76C6C0A694156B07CCA7054BA6902"><enum>(i)</enum><text>any medical care—</text> 
<subclause id="HC1E5020074E849C482FAF033D9493300" commented="no"><enum>(I)</enum><text display-inline="yes-display-inline">which is attested to by the physician or practitioner treating the low-income uninsured individual as being not medically necessary, or</text></subclause> 
<subclause id="HD02B556D414C4967A924E87893855F64" commented="no"><enum>(II)</enum><text>with respect to which the low-income uninsured individual signs a waiver acknowledging such care is not medically necessary, and</text></subclause></clause> 
<clause id="HF8FA0C4F1C86404E863371CEBBE0A900"><enum>(ii)</enum><text>any organ transplant, any medical care that is cosmetic or experimental in nature, and any treatment to improve the functioning of a malformed member.</text></clause></subparagraph></paragraph> 
<paragraph id="H8AAF38618B7A429FA9D4635BD2CAED"><enum>(3)</enum><header>Low-income uninsured individual</header> 
<subparagraph id="H3D204457A37349CF82C19347196CD65F"><enum>(A)</enum><header>In general</header><text>The term <quote>low-income uninsured individual</quote> means any individual who, at the time the medical care is sought—</text> 
<clause id="H62E7EB44F94949168311B588D432325"><enum>(i)</enum><text display-inline="yes-display-inline">is not covered by insurance constituting medical care, other than coverage described in section 223(c)(1)(B),</text></clause> 
<clause id="H4F35374070584FB694C5202DF95B288B"><enum>(ii)</enum><text display-inline="yes-display-inline">has an annual household income equal to not more than 200 percent of the poverty line applicable to the size of the family involved, </text></clause> 
<clause id="HD96A372ADA7B4B06BD7B37747B40AD03" commented="no"><enum>(iii)</enum><text display-inline="yes-display-inline">does not fail the resource requirement of subparagraph (D) or (E) of section 1860–14(a)(3) of the Social Security Act,</text></clause> 
<clause id="H2D39620072694C1700A59023266E11B1" commented="no"><enum>(iv)</enum><text>is a citizen or resident of the United States, and</text> </clause> 
<clause id="HD5DB21E784B4442F8276D92390FB3BD9" commented="no"><enum>(v)</enum><text>is not eligible for government-sponsored insurance constituting medical care.</text></clause></subparagraph> 
<subparagraph id="HFFBE66BD670C4EB9984CE682629729F9"><enum>(B)</enum><header>Exception</header><text>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.</text></subparagraph></paragraph> 
<paragraph id="HB2A47EA675014AC881A4DDE7825B6413"><enum>(4)</enum><header>Poverty line</header><text display-inline="yes-display-inline">The term <quote>poverty line</quote> has the meaning given such term in section 673 of the Community Services Block Grant Act (<external-xref legal-doc="usc" parsable-cite="usc/42/9902">42 U.S.C. 9902</external-xref>).</text></paragraph></section></subchapter><after-quoted-block>.</after-quoted-block></quoted-block></subsection> 
<subsection id="H82EB03D6F24C41E792EBDEFB0300A104"><enum>(b)</enum><header>Conforming amendment</header><text>The table of subchapters for chapter 42 of such Code is amended by adding at the end the following new item:</text> 
<quoted-block style="OLC" id="H9487E6AFEEB9484A99D0ACD4D0B8B9C1" display-inline="no-display-inline"> 
<toc regeneration="no-regeneration"> 
<toc-entry level="subchapter">Subchapter H. Failure by specified medical care provider to meet minimum charity care requirement.</toc-entry></toc><after-quoted-block>.</after-quoted-block></quoted-block></subsection> 
<subsection id="HBEA820106C4849B0ABC1460002A6A993"><enum>(c)</enum><header>Effective date</header><text>The amendments made by this section shall apply to taxable years beginning after December 31, 2007.</text></subsection></section> 
</legis-body> 
</bill> 


