Skip to Content

Filter by:

Washington Highlights

IRS Issues Proposed CHNA Rule

April 5, 2013—The Internal Revenue Service (IRS) April 3 issued a notice of proposed rulemaking, Community Health Needs Assessments for Charitable Hospitals.  There is a 90-day comment period. The proposed rule implements a requirement in the Affordable Care Act (ACA, P.L. 111-148 and P.L. 111-152)  that all 501(c)(3) hospitals must conduct a community health needs assessment (CHNA) every three years and adopt an implementation strategy to meet the community health needs identified through the CHNA.

In the proposed rule, the IRS attempted to provide hospitals with flexibility in implementing the ACA provisions. For example, a hospital is able to take into account all of the relevant facts and circumstances in defining the community it services, but may not exclude medically underserved, low-income, or minority populations who are part of its patient population. The IRS also proposes that rather than identifying all of the community health needs, the CHNA only needs to identify and prioritize significant health needs. 

Failure to comply with this or other related provisions added to the tax code by the ACA can result in a the loss of 501(c)(3) status.  The proposed rule discusses implementation of this provision.  Of note, the IRS proposes this penalty will not apply in the case of minor or inadvertent omissions or errors as long as the hospital makes a correction promptly after the omission or error is discovered.

In the coming weeks the AAMC will be providing members with additional information through a teleconference and will welcome feedback that will be considered for incorporation into a comment letter.


Ivy Baer, J.D., M.P.H.
Senior Director and Regulatory Counsel
Telephone: 202-828-0499


envelope on a green background

Subscribe to Washington Highlights

RSS icon

Subscribe to RSS

Washington Highlights, a weekly electronic newsletter, features brief updates on the latest legislative and regulatory activities affecting medical schools and teaching hospitals.

Past Issues

For More Information

Jason Kleinman
Sr. Legislative Analyst, Govt. Relations
Telephone: 202-903-0806