A Congressional discussion draft released May 12, 2026, would significantly expand the information that tax-exempt hospitals must report annually on their Form 990. The draft amends Section 6033 of the Internal Revenue Code by adding a new subsection (p) and would apply to every organization described in IRS Code Section 501(r)(2) that is required to file a Form 990. This is the third in a series of recent developments surrounding proposed changes to the Form 990 for all IRS Code Section 501(c)(3) organizations and specifically to tax-exempt hospitals.
The Treasury Department announced on April 23, 2026, a new initiative to revise Form 990, aimed at increasing transparency and accountability for tax‑exempt organizations, including clearer reporting on:
The Congressional Research Service, a group of non-partisan shared staff, released on March 30, 2026, a summary entitled Nonprofit Hospitals, Tax Benefits, and Charity Care. The summary addressed the following and noted potential options for revisions prospectively:
Caution: This is a discussion draft only and subject to revisions — not enacted law. Several provisions remain undefined and are subject to change.
Reporting granularity: Items 2 through 7 must be reported both in the aggregate for the hospital and separately for each hospital facility — a significant new compliance burden for multi-facility hospital entities.
For the organization and each hospital facility it operates.
Community benefits, charity care, advertising, quality improvement, and nonclinical programming.
Currently undefined — the tax that would apply under Chapter 1 if the organization were not tax-exempt.
Currently undefined — a description of each, plus revenue generated and costs of each, as reported to CMS.
The highest-priority needs from the CHNA (IRS Code Section 501(r)(3)) and spending on programs addressing each.
Must disclose the number of financial assistance applications received, granted, and denied under the hospital’s financial assistance policy (IRS Code Section 501(r)(4)).
Individuals dispensed 340B covered outpatient drugs, and aggregate net revenue less aggregate participation/compliance costs.
Nonprofit hospitals should begin assessing whether current systems can capture facility-level detail on community benefit spending, financial assistance, and 340B economics. Early data-readiness planning will be critical given the potentially compressed effective-date window.
Reach out to our Healthcare Services Team to discuss how these proposed changes may affect your organization.
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