SB 80: Tax Credits; the definition of "rural hospital organization"; revise

Georgia law gives tax credits to donors who support qualifying rural hospital organizations, under a definition in O.C.G.A. § 31-8-9.1. Currently, that definition requires the hospital to be an acute care hospital that provides inpatient services at a facility located in a rural county or that is a critical access hospital. Senate Bill 80 changes that definition in two main ways. First, it adds rural freestanding emergency departments to the list of facilities that can qualify as a rural hospital organization, alongside acute care hospitals. Second, it replaces the requirement that a facility 'provide inpatient hospital services' in a rural county with a requirement that the organization simply have its primary campus located in a rural county or be a critical access hospital. The bill also fixes capitalization of the word Medicare in two places. All other existing eligibility requirements, such as accepting Medicaid and Medicare patients, serving indigent patients, and meeting financial reporting standards, remain unchanged.

• Adds rural freestanding emergency departments to the types of facilities that can qualify as a 'rural hospital organization' eligible for tax credit donations, alongside acute care hospitals.
• Changes the location test from 'provides inpatient hospital services at a facility' in a rural county to having the organization's 'primary campus' located in a rural county or being a critical access hospital.
• Corrects the spelling of 'Medicare' from lowercase 'medicare' to properly capitalized 'Medicare' in the Medicaid and Medicare participation requirement.
• Leaves unchanged the other existing eligibility criteria, including indigent care levels, IRS Form 990 filing, tax-exempt status, audit compliance, and the patient margin cap.

Rural hospitals and rural freestanding emergency departments in Georgia, donors who claim state tax credits for contributing to rural hospital organizations, and the Georgia Department of Community Health, which certifies eligibility and calculates statewide patient margin averages.

By adding freestanding emergency departments and loosening the location requirement to 'primary campus' rather than where inpatient services are provided, the bill could let more rural facilities qualify for the tax credit program, potentially expanding the pool of organizations eligible to receive tax-credited donations that support rural health care.

• Section 1 amends paragraph (3) of subsection (a) of O.C.G.A. § 31-8-9.1 to add 'rural freestanding emergency department' to the entities that can be a 'rural hospital organization'.
• Subparagraph (A) is revised so eligibility depends on the organization having its primary campus in a rural county or being a critical access hospital, rather than where it provides inpatient hospital services.
• Subparagraph (B) corrects capitalization of 'Medicare' but keeps the existing requirement to participate in and accept both Medicaid and Medicare patients.
• Subparagraphs (C) through (H), covering indigent care levels, IRS filings, tax-exempt status, audits, and patient margin limits, are unchanged by the bill.
• Section 2 repeals any conflicting laws.

1. 2025-02-04Senate Read and Referred (Senate)
2. 2025-02-03Senate Hopper (Senate)

• Carden Summers (R, SD-013)Primary sponsor
• John Kennedy (R, SD-018)
• Jason Anavitarte (R, SD-031)
• Ed Harbison (D, SD-015)
• Larry Walker (R, SD-020)
• Marty Harbin (R, SD-016)
• David Lucas (D, SD-026)
• Ricky Williams (R, SD-025)
• Lee Anderson (R, SD-024)
• Freddie Sims (D, SD-012)
• Derek Mallow (D, SD-002)
• Sam Watson (R, SD-011)
• Billy Hickman (R, SD-004)
• Kenya Wicks (D, SD-034)
• Nikki Merritt (D, SD-009)

• rural hospitals
• tax credits
• health care funding
• emergency departments
• Medicaid and Medicare