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Grassley Seeks 'More Active and Serious' AHA Role in Improving Care for the Poor

MARCH 10, 2006 -- Senate Finance Committee Chairman Charles E. Grassley is urging the American Hospital Association to help him develop legislation that would improve nonprofit care for low-income Americans.

The letter comes amid a broad-based inquiry by Grassley and the House Ways and Means Committee into what tax-exempt organizations should be required to do to retain that status.

Noting that the lobby recently offered his staff several legislative options to that end, Grassley praised AHA's decision to "show leadership," but urged it to "take a more active and serious role in this discussion."

In a March 8 letter, Grassley listed three legislative options offered by AHA:

  • Discounts: The option "requires hospitals to provide discounts to all uninsured individuals of limited means and then make that discount publicly available," Grassley wrote. He asked AHA how the discounts should be calculated, how to define those of "limited means," and whether "those in financial straits because of a catastrophic illness should be included."
  • 'Community benefit' disclosure: This option would require hospitals to adopt a common definition of the "community benefit" they provide, and to tell the public "the amount" of that benefit they provide. Among other things, Grassley wants to know how AHA would calculate the community benefits a hospital provides.
  • Governance: A third option includes provisions for "strengthening transparency, governance, and accountability of charitable organizations," Grassley said. He asked AHA to provide more detail on these provisions.

Grassley said discounts to the uninsured and measuring charity care and community benefit are important, but added that he has concerns about other practices of non-profit hospitals. As examples he mentioned investments in joint ventures and "taxable subsidiaries," executive compensation, and billing and collection practices, among others.

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