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

substantially changed procedures for group exemption, presumably to address creative use of this opportunity by some organizations in recent years, in a fashion that the IRS admitted may impose additional administrative burdens.

      In a time when guidance from the IRS as to exempt organization matters has significantly declined due to staffing and budget challenges, it can still be found in unlikely places. We have previously reported about the use of instructions to the Form 1023 and the Form 990 as a means of informally establishing new procedures and policies. This year we were able to glean meaningful intelligence from GAO reports issued in response to congressional inquiries that provided new detail as to IRS audit procedures and matters of interest.

      As this supplement was going to press, a new president and a new administration were coming into view. Certainly, the election of President Biden portends the end of legislative efforts to undo the Affordable Care Act and the beginning of new efforts to strengthen and expand it. It seems likely that a federal government now controlled by the Democratic Party will move in new directions that are certain to result in changes to the law of tax‐exempt healthcare organizations. Stay tuned to this channel for breaking developments.

      As always, we appreciate the assistance we have received from John Wiley & Sons in the preparation of this cumulative supplement. Our thanks are extended, in particular, to Brian T. Neill, development editor, Deborah Schindlar, project editor, and Jayaprakash Unni, production editor, for their assistance and support and connection with this cumulative supplement.

      Thomas K. Hyatt

      Bruce R. Hopkins

      February 2021

About the Authors

      Thomas K. Hyatt is a partner in the law firm Dentons US LLP, resident in the Washington, DC office. His practice is focused on corporate and tax‐exempt organization issues for nonprofit organizations. He has particular expertise in legal issues affecting tax‐exempt healthcare providers and in governance and public policy issues affecting tax‐exempt higher education institutions. Mr. Hyatt has represented organizations including public and private hospitals, multihospital systems, integrated delivery systems, academic medical centers, home health agencies, health maintenance organizations, continuing care retirement communities, provider associations, physician clinics, faculty practice plans, physician‐hospital organizations, and shared services organizations in such matters. He also frequently works with nonprofit governing boards and board committees to address such issues as regulatory compliance, fiduciary duty, conflicts of interest, bylaws development and revision, senior management compensation and benefits, chief executive contracts and transition, fundraising, lobbying and political campaign activity, board development, policy development, adoption of best governance practices, membership matters, corporate restructuring, mergers, and joint ventures. He is admitted to practice in the District of Columbia and Pennsylvania.

      Mr. Hyatt is a member of the American Health Lawyers Association (AHLA), the American Bar Association, and the District of Columbia Bar. He served as a member of AHLA's Board of Directors from 1992 to 1998. Mr. Hyatt is one of the inaugural Fellows of AHLA. He is the Chair Emeritus and on the faculty of the annual Tax Issues in Healthcare Organizations seminar sponsored by AHLA, and is also the past chair of AHLA's Tax and Finance Practice Group. In 2004, Mr. Hyatt received AHLA's David J. Greenburg Service Award. He also serves as Senior Fellow for Public Policy with the Association of Governing Boards of Universities and Colleges. He has been listed in Best Lawyers in America since 2005 and as a DC Super Lawyer. He has also been listed in Chambers USA Healthcare, District of Columbia, since 2012. Mr. Hyatt is a licensed consultant for the Standards for Excellence Institute. He frequently lectures on business and tax planning issues for nonprofit organizations and has written numerous articles for publication on tax‐exempt organization topics. Mr. Hyatt received the 2017 Outstanding Nonprofit Lawyer award from the American Bar Association.

Mr. Hyatt is a 1979 cum laude graduate of Boston College, and received his law degree in 1982 from the University of Pittsburgh, where he served as editor‐in‐chief of the Journal of Law and Commerce.

      Bruce R. Hopkins is the principal in the law firm Bruce R. Hopkins Law Firm, LLC, in Kansas City, Missouri. He concentrates on the representation of tax‐exempt organizations, including healthcare organizations. His practice ranges over the entirety of law matters involving exempt organizations, with emphasis on the formation of nonprofit organizations, acquisition of recognition of tax‐exempt status for them, governance and the law, the private inurement and private benefit doctrines, the intermediate sanctions rules, legislative and political campaign activities issues, public charity and private foundation rules, unrelated business planning, use of exempt and for‐profit subsidiaries, joint venture planning, tax shelter involvement, review of annual information returns, Internet communications developments, the law of charitable giving (including planned giving), and fundraising law issues.

      Mr. Hopkins is the Professor from Practice at the University of Kansas School of Law, where he teaches courses on the law of nonprofit and tax‐exempt organizations.

      Mr. Hopkins served as Chair of the Committee on Exempt Organizations, Tax Section, American Bar Association; Chair, Section of Taxation, National Association of College and University Attorneys; and President, Planned Giving Study Group of Greater Washington, DC.

Mr. Hopkins is the series editor of Wiley's Nonprofit Law, Finance, and Management Series. In addition to coauthoring The Law of Tax‐Exempt Healthcare Organizations, Fourth Edition, he is the author of The Law of Tax‐Exempt Organizations, Twelfth Edition; Planning Guide for the Law of Tax‐Exempt Organizations: Strategies and Commentaries; Tax‐Exempt Organizations and Constitutional Law: Nonprofit Law as Shaped by the U.S. Supreme Court; Bruce R. Hopkins’ Nonprofit Law Dictionary; Bruce R. Hopkins’ Nonprofit Law Library (e‐book); IRS Audits of Tax‐Exempt Organizations: Policies, Practices, and Procedures; The Tax Law of Charitable Giving, Fifth Edition; The Law of Fundraising, Fifth Edition; The Tax Law of Private Foundations, Fifth Edition; The Tax Law of Associations; The Tax Law of Unrelated Business for Nonprofit Organizations; The Nonprofits’ Guide to Internet Communications Law; The Law of Intermediate Sanctions: A Guide for Nonprofits; Starting and Managing a Nonprofit Organization: A Legal Guide, Seventh Edition; Nonprofit Law Made Easy; Charitable Giving Law Made Easy; Private Foundation Law Made Easy; Fundraising Law Made Easy; 650 Essential Nonprofit Law Questions Answered; The First Legal Answer Book for Fund‐Raisers; The Second Legal Answer Book for Fund‐Raisers; The Legal Answer Book for Nonprofit Organizations; and The Second Legal Answer Book for Nonprofit Organizations. He is the coauthor, with David O. Middlebrook, of Nonprofit Law for Religious Organizations: Essential Questions and Answers; with Douglas K. Anning, Virginia C. Gross, and Thomas J. Schenkelberg, of The New Form 990: Law, Policy, and Preparation; with Ms. Gross, of Nonprofit Governance: Law, Practices & Trends; and with Ms. Gross and Mr. Schenkelberg, of Nonprofit Law for Colleges and Universities: Essential Questions and Answers for Officers, Directors, and Advisors. He also writes Bruce R. Hopkins’ Nonprofit Counsel, a monthly newsletter published by John Wiley & Sons.

      Mr. Hopkins maintains a website providing information about the law of tax‐exempt organizations, including healthcare organizations, at www.brucerhopkinsbooks.com. Material posted on this site includes a periodically updated current developments outline and indexes for his newsletter. Mr. Hopkins received the 2007 Outstanding Nonprofit Lawyer Award (Vanguard Lifetime Achievement Award) from the American Bar Association, Section of Business Law, Committee on Nonprofit Corporations. He is listed in the Best Lawyers in America, Nonprofit Organizations/Charities Law, 2007–2021.

      Mr. Hopkins earned his JD and LLM degrees at the George Washington University National Law Center, his SJD at the University of Kansas School of Law, and his BA at the University of Michigan. He is a member of the bars of the District of Columbia and the state of Missouri.

Book Citations

      Throughout