The Law of Tax-Exempt Healthcare Organizations

The Law of Tax-Exempt Healthcare Organizations
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Get up to date on tax-exempt healthcare law and relevant issues The Law of Tax-Exempt Healthcare Organizations, Fouth Edition provides complete and comprehensive information and analysis in a single volume – this is the e-book version. Tackling complex legal issues with plain-English explanations and the appropriate citations, this guide is a must-have resource for organizations and their advisors. Healthcare law is a complex field, and keeping up with the frequent changes to federal law is itself a full time job. This book eliminates the need for extended research time by collecting the relevant guidelines into one place.

Оглавление

Bruce R. Hopkins. The Law of Tax-Exempt Healthcare Organizations

Table of Contents

Guide

Pages

the law of tax-exempt healthcare organizations

2020 Cumulative Supplement

Preface

About the Authors

Book Citations

CHAPTER ONE Tax‐Exempt Healthcare Organizations: An Overview

§ 1.2 DEFINING TAX‐EXEMPT ORGANIZATIONS

§ 1.5 CHARITABLE HEALTHCARE ORGANIZATIONS

§ 1.8 PROMOTION OF HEALTH

§ 1.10 ABLE PROGRAMS

NOTES

CHAPTER THREE Public Charities and Private Foundations (New)

§ 3.3 COMMERCIALITY DOCTRINE (c) Contemporary View

(d) Commerciality Doctrine and Healthcare Organizations

NOTES

CHAPTER FOUR Private Inurement, Private Benefit, and Excess Benefit Transactions

§ 4.4 PRIVATE INUREMENT—SCOPE AND TYPES

*(j) Provision of Healthcare Services to One Individual or Family

(k) Business Referral Operations

(l) Still Other Forms of Inurement

§ 4.6 ESSENCE OF PRIVATE BENEFIT

§ 4.9 EXCESS BENEFIT TRANSACTIONS (a) General Rules

NOTES

CHAPTER FIVE Public Charities and Private Foundations

§ 5.1 PUBLIC INSTITUTIONS

§ 5.6 RECOGNITION OF CHANGE IN PUBLIC CHARITY STATUS

NOTES

CHAPTER SEVEN Lobbying and Political Activities

§ 7.1 LEGISLATIVE ACTIVITIES LIMITATION (b) Legislative Activities

§ 7.4 POLITICAL ACTIVITIES LIMITATION (b) Participation or Intervention

(g) IRS's Recent Enforcement Efforts

(h) “Religious Liberty” Executive Order

§ 7.5 BUSINESS EXPENSE DEDUCTION RULES AND POLITICAL ACTIVITIES

§ 7.7 PUBLIC POLICY ADVOCACY ACTIVITIES

§ 7.8 POLITICAL ACTIVITIES OF SOCIAL WELFARE ORGANIZATIONS

NOTES

CHAPTER EIGHT Hospitals

§ 8.3 PUBLIC HOSPITALS

NOTES

CHAPTER NINE Managed Care Organizations

§ 9.3 COMMERCIAL‐TYPE INSURANCE PROVIDERS

§ 9.5 RECENT DEVELOPMENTS

NOTES

CHAPTER THIRTEEN Other Provider and Supplier Organizations

§ 13.3 QUALIFIED NONPROFIT HEALTH INSURANCE ISSUERS

§ 13.5 ACCOUNTABLE CARE ORGANIZATIONS

*§ 13.6 CANNABIS‐RELATED SERVICES ORGANIZATIONS

NOTES

CHAPTER SIXTEEN For‐Profit Subsidiaries

§ 16.3 ATTRIBUTION OF SUBSIDIARY'S ACTIVITIES TO EXEMPT PARENT

NOTES

CHAPTER SEVENTEEN Exempt and Nonexempt Cooperatives

§ 17.1 COOPERATIVE HOSPITAL SERVICE ORGANIZATIONS

NOTE

CHAPTER EIGHTEEN Business Leagues

*§ 18.1 BUSINESS LEAGUES IN GENERAL

§ 18.2 HEALTHCARE TRADE ASSOCIATIONS

*§ 18.3 CERTIFICATION ORGANIZATIONS AND PEER REVIEW BOARDS

NOTES

CHAPTER NINETEEN Other Health‐Related Organizations

§ 19.4 HOSPITAL MANAGEMENT SERVICES ORGANIZATIONS

§ 19.5 REGIONAL HEALTH INFORMATION ORGANIZATIONS

NOTES

CHAPTER TWENTY Healthcare Provider Reorganizations

§ 20.1 SOME BASICS ABOUT REORGANIZATIONS

CHAPTER TWENTY‐ONE Mergers and Conversions

§ 21.4 CONVERSION FROM NONEXEMPT TO EXEMPT STATUS (b) Federal Tax Law

*§ 21.5 JOINT OPERATING AGREEMENTS

NOTES

CHAPTER TWENTY‐TWO Partnerships and Joint Ventures (New)

§ 22.9 WHOLE‐HOSPITAL JOINT VENTURES

CHAPTER TWENTY‐FOUR Tax Treatment of Unrelated Business Activities

§ 24.2 DEFINITION OF TRADE OR BUSINESS (a) General Principles

(b) Profit Motivation Requirement

(f) Concept of Investment Plus

§ 24.3 DEFINITION OF REGULARLY CARRIED ON (a) General Principles

(c) Fundraising Activities

§ 24.5 APPLICATION OF SUBSTANTIALLY RELATED TEST TO HEALTHCARE ORGANIZATIONS

*§ 24.5A DEEMED UNRELATED BUSINESS INCOME

§ 24.11 PHARMACY, MEDICAL SUPPLIES, AND SERVICE SALES (a) Sales of Other Services

§ 24.12 LABORATORY TESTING SERVICES

§ 24.13 MEDICAL RESEARCH

§ 24.18 OTHER EXCEPTIONS TO UNRELATED INCOME TAXATION (a) Exceptions for Activities

(b) Exceptions for Income

§ 24.20 REVENUE FROM CONTROLLED ORGANIZATIONS (b) Special Rule

*§ 24.20A PARTNERSHIP RULES

§ 24.21 UNRELATED DEBT‐FINANCED INCOME (b) Acquisition Indebtedness

§ 24.23 COMPUTATION OF UNRELATED BUSINESS TAXABLE INCOME

(a) General Rules

*(b) Fringe Benefit Rules

*(c) “Bucketing” Rule

(d) Charitable Deduction

(e) Net Operating Losses

(f) Tax Structure

NOTES

CHAPTER TWENTY‐FIVE Physician Recruitment and Retention

§ 25.5 SPECIFIC RECRUITMENT AND RETENTION TECHNIQUES (b) Income Guarantees

NOTES

CHAPTER TWENTY‐SIX Charity Care

§ 26.6 DEFINITIONAL AND REPORTING ISSUES

§ 26.9 CHARITY CARE AND NATIONAL HEALTH REFORM

§ 26.10 ADDITIONAL STATUTORY REQUIREMENTS FOR HOSPITALS (d) New IRS Notice of Anticipated Regulations

(e) Initial Notice of Proposed Rulemaking—Community Health Needs Assessments, and Related Rulemaking and Notices

(f) Final Regulations—Community Health Needs Assessments for Charitable Hospitals, Excise Tax Returns, and Time for Filing Return

§ 26.12 PROVIDER TAXES (NEW)

NOTES

CHAPTER TWENTY‐SEVEN Worker Classification and Employment Taxes

§ 27.7 MEDICAL RESIDENTS AND THE STUDENT EXCEPTION

CHAPTER TWENTY‐EIGHT Compensation and Employee Benefits

§ 28.3 EXECUTIVE COMPENSATION (d) Loans to Executives

(f) Executive Compensation in Certain Health Insurance Providers

§ 28.5 OVERVIEW OF EMPLOYEE BENEFITS LAW

§ 28.6 DEFERRED COMPENSATION IN GENERAL

(c) New Proposed Rules for 457(f) Plans

*§ 28.7 EXCESS EXECUTIVE COMPENSATION (NEW)

Purpose and Overview

NOTES

CHAPTER THIRTY Tax‐Exempt Bond Financing

§ 30.3 DISQUALIFICATION OF TAX‐EXEMPT BONDS

(d) Avoiding Management Contract Problems

NOTES

CHAPTER THIRTY‐ONE Fundraising Regulation

§ 31.2 FEDERAL LAW REGULATION (a) Substantiation Requirements in General

NOTES

CHAPTER THIRTY‐THREE Governance

§ 33.3 GOOD GOVERNANCE PRACTICES (b) Nonprofit Sector Group Best Practice Recommendations

§ 33.4A IRS RULING POLICY

NOTES

CHAPTER THIRTY‐FOUR Exemption and Public Charity Recognition Processes

§ 34.1 EXEMPTION RECOGNITION PROCESS

(a) General Procedures

(b) The Completed Application

(b‐1) Application Processing Time Line

(d) Application Forms in General

(e) User Fees

(f) Applications Processing Controversy

§ 34.5 PUBLIC CHARITY STATUS (b) Recognition of Public Charity Status

*§ 34.6 GROUP EXEMPTION

§ 34.7A NOTICE REQUIREMENTS FOR SOCIAL WELFARE ORGANIZATIONS (NEW)

§ 34.8 PROCEDURE WHERE DETERMINATION IS ADVERSE

*§ 34.9 CONSTITUTIONAL LAW ASPECTS OF PROCESS

NOTES

CHAPTER THIRTY‐FIVE Maintenance of Tax‐Exempt Status and Avoidance of Penalties

§ 35.1 MATERIAL CHANGES

(a) General Rules

(b) Redomestications

§ 35.2A MODIFICATION OF TAX EXEMPTION (NEW)

§ 35.4 REDESIGNED ANNUAL INFORMATION RETURN

§ 35.5 DISCLOSURE REQUIREMENTS (a) Applications and Annual Information Returns

§ 35.6 IRS DISCLOSURE TO STATE OFFICIALS

NOTES

CHAPTER THIRTY‐SIX IRS Audits of Healthcare Organizations

§ 36.2 AUDIT PROCEDURES

(f) Government Accountability Office 2015 Report

(g) IRS Fiscal Year 2016 Work Plan

(h) IRS Fiscal Year 2017 Work Plan

(i) IRS Fiscal Year 2018 Work Plan

(j) IRS Fiscal Year 2019 Program Letter

(k) IRS Fiscal Year 2020 Program Letter

*(l) Section 501(r) Audits

NOTES

Cumulative Table of Cases

Cumulative Table of IRS Revenue Rulings

Cumulative Table of IRS Revenue Procedures

Cumulative Table of IRS Private Letter Rulings

Cumulative Table of IRS Technical Advice Memoranda

Table of Chief Counsel Advice Memoranda

Cumulative Table of IRS General Counsel Memoranda

Table of Tax Reform Legislation

OVERVIEW OF LEGISLATION

TAX‐EXEMPT ORGANIZATIONS LAW CHANGES

INCOME TAX CHARITABLE DEDUCTION LAW CHANGES

DELETED PROPOSALS

NOTES

Cumulative Index

WILEY END USER LICENSE AGREEMENT

Отрывок из книги

Thomas K. Hyatt and Bruce R. Hopkins

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The IRS determined that the organization does not meet the operational test because a substantial part of its activities does not further exempt purposes. In its view, the organization created, maintained, developed, promoted, and provided governance and direction to the development of blockchain technology as a commercial enterprise. The IRS concluded that providing blockchain technology to payers, providers, and financial institutions for use in the conduct of their businesses is not educational within the meaning of the Code. It found that the organization operated in a manner similar to a trade or business primarily carried on for profit and that its services were not inherently charitable.

The IRS has also found that an organization that provides a menu of services to healthcare companies does not qualify as a tax‐exempt charitable organization. The services comprised billing, legal, accounting, human resources, personnel, and support staffing. It also provided spiritual, emotional, and physical support services to patients. All of the organization's revenue came from billing and managerial services. The IRS found that the organization failed to satisfy the organizational test for qualification as a charitable organization because its governing documents do not limit its purposes to one or more exempt purposes. It found that the organization was very similar to an organization that did not qualify for tax exemption because providing services to other exempt organizations at cost is not sufficient to characterize the activity as charitable due to the lack of a donative element. The organization's primary activities, which included managing the administrative and medical services of a for‐profit entity for a fee, do not fulfill a charitable educational or religious purpose and they directly compete with other providers of similar services.

.....

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