Montana Looks to Increase Transparency for Nonprofit Hospital Charity Care Standards 

By Consumers for Quality Care, on August 14, 2024

The Montana Department of Public Health and Human Services (DPHHS) is working to learn more about the level of charity care and community benefits nonprofit hospitals are providing in exchange for their tax-exempt status, according to KFF Health News. 

As part of the new proposed guidelines, the state DPHHS will begin collecting data on how nonprofit hospitals discount prices for eligible consumers, provide health-education services, and conduct free preventive screenings. 

While the new proposals are long overdue, experts worry that the data collection does not go far enough. Kevin Barnett, a Senior Investigator at the Public Health Institute, a California-based nonprofit that studies hospitals and the community benefits they provide, stated, “What is being proposed in Montana doesn’t really move the needle. It kicks the can down the road to say ‘we’ll consider this another day.’” Barnett stresses that what really matters is what state officials do with this information and what measures they’ll take to ensure that nonprofit hospitals are providing adequate charity care.  

Nonprofit hospitals have often been found to skimp on charity care, despite their status as charitable organizations. A state audit conducted in 2020 found that current hospital reporting standards are insufficient and vague. A KFF Health News investigation conducted in 2021 revealed that nonprofit hospitals in the state with large operating budgets failed to provide adequate charity care and community benefits. 

Although federal law requires nonprofit hospitals to provide “community benefits” to maintain tax-exempt status, it does not detail what or how much care must be provided, giving hospitals broad leeway to interpret these requirements in ways favorable to them. In 2023, the state DPHHS started tracking the amount of care provided by the state’s hospitals. The new proposed standards create more requirements; they also give the state more authority to pass stricter protocols.  

CQC has given Montana nonprofit hospitals a failing grade for not providing adequate community benefits and charity care, failing to comply with federal price transparency requirements, and exacerbating the medical debt crisis. 

CQC urges nonprofit hospitals to hold up their end of the bargain to better serve their communities and deliver care for patients when they need it most.