COLUMBUS, Ohio -- For the second time in as many years, Ohio's top law enforcer is seeking information on 174 Ohio hospitals that get tax breaks linked to their status as nonprofit, charitable organizations.
Attorney General Marc Dann, a Democrat elected in January, wants the institutions to justify their tax-exempt status and has launched an effort to collect detailed data on their operations, including how much they pay their executives, how they collect unpaid medical bills, how much charity care they provide, and what financial information they share with the public.
A similar effort by Dann's predecessor, Republican Jim Petro, was largely abandoned in 2006 amid criticism from leaders of hospitals and other nonprofit groups. The attorney general's office enforces laws governing nonprofit organizations.
Petro's initiative sought to have nonprofit hospitals register with the state, outline measures to prevent fraud, file mission statements, outline policies for collecting unpaid bills and prove they were charging indigent patients fair rates.
Dann discussed his ideas last week with the Ohio Hospital Association, which represents the nonprofit hospitals as well as six for-profit medical centers. He acknowledged the latest probe could stir controversy.
"Anytime you start to hold people accountable who have not had that for decades, if not centuries, people are going to start to be nervous," Dann said in an interview with The Columbus Dispatch published Monday. "I think you get more bees with honey than with vinegar. I think we're going to be as collaborative as we can."
Tiffany Himmelrich, a spokeswoman for the Hospital Association, said the hospitals provide many community benefits beyond treating patients who are unable to pay.
"The hospital association is really going to work hard with the attorney general's staff to explain what community benefits the hospitals provide," she said. "It's not just charity care."
Charity care accounted for $816 million of the $2.2 billion that nonprofit hospitals provided in unreimbursed services in 2005, according to the association's 2007 annual report. The rest went to losses on Medicaid and Medicare patients and debts the hospitals wrote off.
The Internal Revenue Service will require more detailed financial accounting from nonprofit hospitals beginning with the 2009 tax year, which may address some of the same questions Dann is asking.
Cathy Levine, executive director of Universal Health Care Action Network of Ohio, a patient-advocacy group, said involving the hospitals at the outset may help Dann succeed where Petro failed.
She suggested Dann scrutinize hospital billing practices to ensure that uninsured and underinsured patients aren't driven to financial ruin by medical bills.
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