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Changes to Compensation Rules for Tax-Exempt Hospitals

The IRS has proposed new rules that will require tax-exempt hospitals (and other tax-exempt entities) to review a variety of compensation arrangements to avoid unintended tax consequences. This article will provide a brief...more

IRS Denial of Accountable Care Organizations Raises More Questions Than It Answers

In a recent ruling, PLR 201615022, the IRS denied tax exemption to an accountable care organization on the basis that the organization was conferring private benefit on its participating physicians by negotiating shared...more

American Hospital Association Urges IRS To Affirm that Tax-Exempt Hospitals Can Participate in Non-Medicare ACOs

The American Hospital Association (AHA) has written to John Koskinen, Commissioner of the Internal Revenue Service (IRS), and Mark Mazur, Assistant Secretary for Tax Policy at the Treasury Department, raising concerns about...more

Corporate Law Governance Update - May 2016

The following developments from the past month offer guidance on corporate law and governance law as they may be applied to nonprofit health care organizations: EXPANDING ROLE OF GENERAL COUNSEL The April 12 survey...more

California Medical Marijuana Regulation and Safety Act: What you need to know

After being the first state to legalize medical marijuana almost 20 years ago, California is implementing regulations across the industry. Commentators have focused on the effective and efficient processes called for in the...more

CMS Issues Final ACO Rules: Key Legal Implications for Hospital & Health System ACOs

On June 4, 2015, the Centers for Medicare & Medicaid Services (CMS) released a final rule (Final Rule) containing changes to its Medicare Shared Savings Program (MSSP). Some of the changes codify informal guidance that the...more

OIG issues additional guidance to healthcare boards regarding compliance efforts and oversight

The Office of the Inspector General (OIG) of the U.S. Department of Health and Human Services, together with leading legal, audit and compliance collaborators, recently issued the fourth in a series of publications providing...more

Hospital For-Profit Conversion Hits Bicoastal Speed Bumps

Over the past decade or so, the conversion of nonprofit hospitals to for-profit status seemed to be an inexorable trend. But in the last couple of weeks the movement has run into speed bumps on both coasts....more

IRS Releases Guidance on Private Business Use, and ACOs and Management Contracts

On October 25, 2014, the Internal Revenue Service (the IRS) released Notice 2014-67 that provides interim guidance on (i) participation in the Medicare Shared Savings Program through an accountable care organization (ACO) and...more

Hospital Conversion to For-Profit Status Improves Health (i.e., Financial Health)

For years the debate has raged: Does conversion of a nonprofit hospital to for-profit status result in a decline in clinical quality? An improvement? More efficient operations? A decrease in the volume of indigent and...more

Perspectives - Trends and topics in not-for-profit management - September 2014

In this Issue: - Not-for-Profit Volunteers: HIPAA Compliance & Training - Not-for-Profit Spotlight: Project Sunshine - 10 Ways to Lose Your Not-for-Profit Status - Economic Development...more

To Pay (Directors) or Not to Pay – That is the Question

The question of whether to pay the directors of a tax-exempt organization is hotly contested. Although this practice is legal, there can be drawbacks with providing compensation. Despite the perceived hesitancy to compensate...more

Retirement Community Qualifies as a Charity

A panel of the Commonwealth Court concluded that a continuing care retirement community qualified as an institution of purely public charity and was therefore exempt from real estate tax, except for a remand regarding...more

Perspectives - January 2014

In This Issue: - Considerations in the Cloud: Managing the Risks - United States V. Sperry: A Revived Threat to Owners, Directors, Managers and Directors of Distressed Organizations - Board Membership &...more

Proposal Seeks To Make California The Artificer And Enforcer Of Caps On Executive Compensation

Earlier this month, Secretary of State Debra Bowen announced that the proponents of an initiative measure could begin collecting petition signatures for their measure. If this measure makes it on to the ballot and is...more

Massachusetts Attorney General Releases Charity CEO Compensation Report

On December 19, the Non-Profit Organizations/Public Charities Division of the Massachusetts Office of the Attorney General released the results of a “focused review” of CEO compensation at 25 of the Commonwealth’s largest...more

Major Reforms for New York Nonprofits Signed Into Law

On December 18, 2013, almost six months after the Non-Profit Revitalization Act of 2013 (the “Act”) passed the New York State Legislature, New York Governor Andrew Cuomo signed the Act into law. The Act amends the patchwork...more

Would Hobby Lobby Stores, Inc. Have A Stronger Case As A Flexible Purpose Corporation?

Steve Hazen alerted me to the fact that California Attorney General Kamala D. Harris has filed an amicus brief in Sebelius v. Hobby Lobby Stores, Inc., U.S. Supreme Court Docket No. 13-354. The question presented in that...more

New York Cracks Down on Executive Compensation for Not-for-Profits

Those powerful words were spoken by New York Governor Andrew M. Cuomo just over two years ago in his announcement of the formation of a task force to combat excessive executive compensation at not-for-profit corporations that...more

A Continued Examination of Charitable Patient Assistance Programs Part Four in a Series: Staying True to the Definition of an...

In today’s challenging health care environment, Charitable Patient Assistance Programs (Charitable PAPs) have emerged to meet the needs of the nearly 30 million Americans that are underinsured and have difficulty paying...more

Transforming Not-for-Profit Governance and Oversight in New York: The Nonprofit Revitalization Act and Executive Compensation...

The New York State Attorney General (AG) has teamed up with lawmakers to introduce two new bills that propose an overhaul of the Not-for-Profit Corporation Law (N-PCL), which has not seen significant change in more than 40...more

Who is a Large Employer Under Obamacare?

Among other things, the Patient Protection and Affordable Care Act (the “Act”), commonly referred to as Obamacare, requires “large employers” to provide qualified health coverage for all of their full-time employees, or pay...more

IRS Issues Proposed Regulations on the New Community Health Needs Assessments Required for Charitable Hospitals

On April 5, 2013, the Internal Revenue Service published proposed regulations (Proposed Regulations) in the Federal Register that provide guidance to charitable hospital organizations on the community health needs assessment...more

Managing Nonprofits in Troubled Times: New Tools in Trustees’ Toolbox

Non-profits, which depend on both the private economy and the public sector, suffer greatly in economic downturns such as we are experiencing at present. Take healthcare, for example. Consider what happened when the...more

New Guidance for Tax-Exempt Hospitals on Community Health Needs Assessment and Other Section 501(r) Requirements

On April 5, the Treasury Department released proposed regulations that provide guidance on the community health needs assessment (“CHNA”) and other requirements for tax-exempt hospitals under section 501(r) of the Internal...more

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