At an Internal Revenue Service hearing today, an AHA witness highlighted four concerns with the agency's proposed rule implementing requirements for tax-exempt hospitals under Section 501(r) of the Patient Protection and Affordable Care Act. "The AHA and its members support Congress' goals in enacting Section 501(r), and hospitals are committed to meeting its requirements," said Andreanna Ksidakis, vice president, Office of the General Counsel at Sutter Health in Sacremento, CA. "The AHA's comment letter and my remarks reflect input from hospitals across the country of all sizes, types and locations, including a member advisory group I had the privilege of leading in 2011 that represented over 300 hospitals. The message we uniformly heard was: one size does not fit all; do not interrupt what's working; and focus on transparency and disclosure to the community." The AHA recommended that: the definition of "reasonable efforts" be changed to eliminate the overly prescriptive requirements; the effective date of the final regulations coincide with implementation of other key features of the Patient Protection and Affordable Care Act; enforcement guidance be issued prior to finalizing the regulations; and the final rule accommodate the unique circumstances of government hospitals that are 501(c)(3) organizations.