Connect with us

Accounting

IRS faces challenges overseeing tax-exempt hospitals

Published

on

The Internal Revenue Service has been facing staffing and budget cutbacks that threaten its ability to carry out its responsibilities, which include overseeing the troubled nonprofit hospital sector.

The report, released earlier this month by the Treasury Inspector General for Tax Administration in response to a request in 2023 from four senators, found that “vague and outdated guidance” is creating challenges for oversight of tax-exempt hospitals. TIGTA noted that the Affordable Care Act requires the IRS to evaluate the community benefit activities of tax-exempt hospitals at least once every three years. In response, the IRS created a group to conduct compliance reviews, known as Community Benefit Activity Reviews, to make sure hospitals adhere to the federal requirements to maintain their tax-exempt status.

Revenue Ruling 69-545 outlines the community benefit standard applicable to tax-exempt hospitals and includes examples of six factors that can demonstrate a tax-exempt hospital’s community benefit. But the vague definition of community benefit makes it hard for both hospitals and the IRS to determine if hospitals are offering enough community benefits to justify their tax exemption. 

Other factors, including whether a hospital provides financial assistance to those unable to pay, are relevant in determining whether a hospital is providing a benefit to the community, the report noted. However, the Internal Revenue Code doesn’t specify what eligibility criteria or level of assistance provided is considered to be adequate for a financial assistance policy to meet the statutory requirements. “Vague or unclear eligibility criteria could potentially cause confusion for patients and inconsistent application of the requirements across hospitals,” said the report.

In April 2022, the IRS revised the scope of its CBARs to focus only on the Affordable Care Act’s statutorily required community benefit standard. As a result, examination referrals dropped 98% from fiscal years 2022 through 2024. 

To address the reduced amount of oversight due to the streamlined CBAR process, the IRS implemented a compliance strategy that aimed to identify potential noncompliance by tax-exempt hospitals. Using the IRS’s data, TIGTA did an analysis of the available filing information to identify tax-exempt hospitals potentially subject to the CBARs and compared it to the IRS’s population of tax-exempt hospitals. TIGTA identified 142 missing tax-exempt hospitals that the IRS should have included in its population but weren’t identified or reviewed. In addition, the IRS excluded 14 governmental unit and 13 church-affiliated hospitals from the population for other reasons. 

TIGTA made four recommendations in the report, suggesting the Treasury Department’s Office of Tax Policy consider a legislative proposal to amend Section 501 of the Internal Revenue Code and any other required provisions of law to define the community benefit standard and establish baseline criteria for tax-exempt hospital financial assistance policy eligibility. TIGTA also recommended the IRS should update its guidance to include reasons for excluding dual status governmental unit and certain church-affiliated hospitals from the CBARs because they are statutorily mandated. The IRS agreed with all four of TIGTA’s recommendations and plans to implement corrective actions.

“The IRS appreciates TIGTA’s analysis and the opportunity to consider improvements in the tax administration of tax-exempt hospitals,” wrote Robert Choi, acting commissioner of the IRS’s Tax-Exempt and Government Entities Division. He pointed out that the Government Accountability Office agreed with TIGTA that Congress should consider specifying in the Internal Revenue Code what services and activities it considers sufficient community benefit to improve the IRS’s ability to oversee tax-exempt hospitals.That would enable the IRS to issue updated regulations that provide more specific guidance. 

However, the IRS will likely face difficulties given the cuts in its staffing and budget in carrying out such oversight. The Trump administration has also emphasized deregulation rather than increased regulation, and the Supreme Court’s decision last year in the Loper Bright case may also constrain its regulatory abilities. Nevertheless, complaints have mounted about tax-exempt hospitals not providing adequate services to their communities. The TIGTA report notes that in 2022, 2,987 (49%) of 6,120 hospitals nationwide were nongovernment, nonprofit hospitals. According to an analysis of Medicare cost reports, 2,927 nonprofit hospitals received $37.4 billion in tax benefits in 2021. However, in 2023, according to the Lown Institute, out of 1,773 nonprofit hospitals it evaluated, 77% spent less on charity care and community investment than the estimated value of their tax breaks.

Continue Reading

Accounting

Continuous Auditing Transforms Corporate ERPs

Published

on

continuous auditing transforms corporate erps

As corporate accounting departments cross the threshold into late July 2026, the adoption of continuous, automated auditing systems has reached a definitive turning point. Driven by advances in artificial intelligence and deep integration with modern Enterprise Resource Planning (ERP) platforms, leading finance organizations are moving away from traditional, periodic post-hoc audits in favor of real-time, 100% transactional verification. This technological transition is redefining internal control environments, reducing compliance costs, and eliminating the structural delays inherent in legacy quarterly closing processes.

Unlike traditional auditing frameworks that rely on statistical sampling—a process that inevitably leaves operational blind spots—continuous auditing software monitors operational data feeds continuously. Every purchase order, electronic invoice, payroll disbursement, and cross-border wire transfer is automatically cross-referenced against established corporate governance parameters, regulatory tax schedules, and anti-fraud algorithms in real time. Anomalies or unauthorized ledger entries are flagged instantly, allowing internal audit teams to investigate and remediate compliance gaps immediately rather than months after the close of a financial period.

The implications for executive financial management are far-reaching. By embedding continuous verification directly into daily transaction workflows, chief financial officers gain uninterrupted visibility into the organization’s true financial standing. Real-time balance sheet auditing eliminates the severe operational bottlenecks associated with month-end and quarter-end financial reconciliations, freeing accounting professionals to focus on strategic financial modeling, tax planning, and capital allocation rather than manual data entry and spreadsheet consolidation.

However, implementing continuous auditing requires accounting leadership to invest heavily in data governance and technical upskilling. Internal audit teams must evolve from manual ledger reviewers into system architects capable of auditing complex algorithms and validating automated data pipelines. Accounting firms and corporate controllers that master continuous auditing will establish a resilient compliance framework capable of meeting stringent international regulatory standards with total transparency.

Continue Reading

Accounting

U.S. Imposes New 50% Tariffs on Canadian Imports Under Rare Legal Provision

Published

on

U.S. Imposes New 50% Tariffs on Canadian Imports Under Rare Legal Provision

WASHINGTON — In a major escalation of cross-border trade friction, U.S. President Donald Trump has signed executive orders imposing new 50% tariffs on a wide selection of Canadian exports, citing discriminatory practices by Ottawa targeting American auto, dairy, and beverage industries.

The new duties, announced Monday, will take effect in 30 days. They target a broad spectrum of consumer and industrial goods—ranging from wine, liquor, and milk products to commercial cement, furniture, clothing, and hockey equipment.

Untested Legal Mechanism

To enact the sweeping measures, the administration invoked Section 338 of the Tariff Act of 1930—a rarely used legal provision allowing the executive branch to levy additional tariffs of up to 50% on foreign nations deemed to discriminate against U.S. commerce.

White House officials noted that Section 338 addresses trade discrimination rather than national security or economic emergencies. The move comes months after prior global emergency tariffs faced legal challenges in domestic courts, signaling Washington’s pivot toward alternate statutory authorities to maintain import duties.

Senior administration officials briefed reporters that the measure directly responds to Canadian provincial bans on U.S. alcohol, restrictions on American vehicle exports, and import quota disparities affecting U.S. dairy and cheese producers relative to third-party trading partners.

“While the administration continues to secure reciprocal trade agreements globally, Canada retaliated against efforts to protect domestic industry,” U.S. Trade Representative Jamieson Greer stated.

USMCA Impact and Carve-Outs

Significantly, the newly ordered 50% duties will apply to designated items even if they otherwise comply with the United States-Mexico-Canada Agreement (USMCA).

However, the administration confirmed key targeted exemptions:

  • Energy products (including oil and natural gas)
  • Potash and critical minerals
  • Fish and seafood
  • Goods already governed by sector-specific duties (such as existing steel and aluminum tariffs)

Administration representatives emphasized that the tariffs do not stem from recent disputes concerning drifting Canadian wildfire smoke, noting that policy options regarding environmental spillover remain under separate review.

Canadian Response and Market Reaction

Following the White House announcement, the Canadian dollar experienced a sharp decline against the U.S. dollar, falling approximately 0.4% during evening trading.

Canadian Prime Minister Mark Carney issued a statement emphasizing that Canada’s earlier counter-duties had merely matched previous U.S. trade actions. “Canada stands ready to engage intensively to address outstanding issues with the U.S. to the mutual benefit of our citizens,” Carney stated, pointing to detailed proposals Ottawa submitted to modernize the USMCA framework.

Ontario Premier Doug Ford took a firmer stance, urging a “dollar-for-dollar” reciprocal response if the measures go into effect on August 19.

With a 30-day implementation window before the duties officially lock in, industry associations and trade groups on both sides of the border are calling for urgent bilateral negotiations to avert further supply chain disruption across North America.

Continue Reading

Accounting

Automated Continuous Auditing: Transforming Compliance and Real-Time Financial Oversight

Published

on

Transforming Compliance and Real-Time Financial Oversight

The traditional accounting paradigm—defined by periodic monthly closures and post-hoc annual audits—is rapidly giving way to continuous, automated financial oversight. As of July 2026, forward-thinking accounting practices and multinational corporate finance departments are leveraging continuous auditing systems powered by advanced machine learning models. These systems monitor operational transactions in real time, shifting audit methodologies from sample-based post-analysis to absolute, 100% transaction-level verification.

The operational advantages of continuous auditing are transformative. Standard auditing procedures historically relied on statistical sampling, which, despite rigorous methodology, inherently left gaps where anomalies or fraudulent transactions could go undetected for months. Modern continuous auditing platforms integrate directly with enterprise resource planning (ERP) databases, instantly cross-referencing purchase orders, invoices, bank feeds, and tax records. Any deviation from established control parameters or unusual transaction behavior triggers immediate flags for internal audit teams, dramatically reducing detection lag from quarters to seconds.

Beyond fraud prevention, continuous auditing fundamentally alters internal reporting and decision-making. Executive leadership no longer has to wait weeks after the close of a quarter to evaluate precise financial standing; real-time verified ledger data provides an uninterrupted view of operating margins, tax liabilities, and cash flow dynamics. This real-time visibility enables corporate controllers to adjust capital allocation strategies dynamically, mitigating liquidity constraints and capitalizing on emerging commercial opportunities far more efficiently than competitors bound to legacy reporting cycles.

However, implementing continuous auditing requires accounting professionals to acquire new analytical capabilities. The role of the auditor is evolving from manual data reconciliation toward system validation, algorithmic model governance, and strategic risk interpretation. Accounting firms and corporate finance departments must invest in continuous technical education, ensuring that audit staff possess the data engineering skills necessary to design, maintain, and evaluate complex automated compliance systems.

Continue Reading

Trending