Congress Subcommittee Talks CHNA

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HPSA Acumen reviewed the question and answer portion of the House Ways and Means Subcommittee on Oversight’s hearing on tax-exempt organizations from Wednesday.

Prepared comments, available here, included testimony from several executives, experts and attorneys working in the U.S. tax-exempt industry. But as we wrote last week, the more important, more telling information would come from the question and answer portion of the hearing available here and starting at time 34:50.

When committee members and invited witnesses spoke on specific issues, they seemed to devote most of their time to issues related to hospitals and universities — what one witness called the two “elephants” of the topic. Universities and hospitals loom large, the witness said, because those categories of tax-exempt organizations make up as much as 80 percent of the spending and capacity of tax-exempt organizations in the United States.

The most interesting exchange was between Rep. Diane Black, R-Tenn., and Michael J. Regier, Senior Vice-President for Legal and Corporate Affairs for VHA Inc., on Community Health Needs Assessment requirements.

Rep. Black’s question starts at 53:54 and Mr. Regier’s comments follow for about five minutes. He said CHNAs are potentially powerful tools for assessing community needs and getting hospitals on track, but that current regulations requiring separate analyses for each individual hospital are too compartmentalized or “siloed.”

“We don’t achieve population health and wellness in that way … ” Regier said.

Rep. Black seemed to agree and said, “I think you make a very good point there. In certain hospital systems, you have one hospital in an area that provides a great deal of community needs and in another sector of that same system, not so much so.”

Rep. Black, as a member of the current Republican majority in the House of Representatives, seemed to indicate her willingness to loosen or alter CHNA and IRS Form 990 compliance rules so that hospital networks can complete more of the compliance work at a corporate, rather than clinical, level. Though it’s important to recall that Wednesday’s discussions and actions are subject to which party controls Congress and the Presidency after this autumn’s elections.

HPSA Acumen staff will keep tabs on developments with the subcommittee as members said repeatedly that it was the first in a series of hearing on this specific topic.

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