Holding Nonprofit Hospitals Accountable Act

This bill amends IRS rules for tax-exempt nonprofit hospitals to require them to meet a new "community benefit standard." It directly affects hospitals receiving federal tax exemptions by mandating they: (1) have community-elected boards, (2) treat Medicare/Medicaid patients without patient limits, and (3) spend 100% of their tax exemption value annually on community services like free care, facility upgrades (capped at 50% of spending), or medical training. The bill also adds reporting requirements for hospitals and creates new annual reviews by the Treasury Inspector General and Comptroller General to monitor compliance. These changes apply to tax years starting after December 31, 2024.