Holding Nonprofit Hospitals Accountable Act

HR 3019, the Holding Nonprofit Hospitals Accountable Act, requires nonprofit hospitals receiving tax exemptions to meet new community benefit standards. It mandates these hospitals to have community-elected boards, treat patients using public programs (like Medicare/Medicaid) without limiting numbers, and spend at least 100% of their annual tax exemptions on specific community services - including patient care training, facility upgrades, and free/discounted care. The bill also requires hospitals to follow Medicare billing rates for financial assistance and establishes annual reviews by the Treasury Inspector General and GAO to monitor compliance and enforcement. These changes apply to taxable years beginning after December 31, 2025, directly affecting nonprofit hospitals that operate under IRS 501(c)(3) status.