November 1, 2024, Covington Alert
In a unanimous decision, the U.S. Court of Appeals for the Fifth Circuit affirmed the Tax Court’s denial of tax-exempt status for Memorial Hermann Accountable Care Organization (MHACO) as an organization described in section 501(c)(4) of the Internal Revenue Code. The decision could have implications for lobbying, political, and member-related activities of social welfare organizations.
Background
As a Texas nonprofit corporation, MHACO provides healthcare to patients under either its “Medicare Shared Savings Program” (MSSP), which specifically benefits Medicare patients, or under employer-sponsored commercial insurance plans.
MHACO applied to the IRS for recognition as a 501(c)(4) organization. The IRS issued a final adverse determination letter, stating that MHACO did not meet the requirements for tax-exempt status of operating exclusively for social welfare purposes because its activities primarily benefitted commercial payors rather than the public.
Legal Issue
The crux of the issue is the permissible threshold of so-called “nonexempt” activity that an organization may engage in and still qualify for exemption. Under one, narrower, legal standard—referred to as a “substantial nonexempt purpose” test and based on the Internal Revenue Code and a 1945 Supreme Court case—the presence of a single substantial nonexempt activity disqualifies an organization from exemption. Under a second legal standard—referred to as the “primary purpose” test and based on the Treasury Regulations—as long as an organization is primarily engaged in exempt activity, it will qualify for exemption. Stated another way, the primary purpose test permits a higher level of nonexempt activity: To the extent the nonexempt activity is not the organization’s primary activity, the organization will qualify for exemption under this second test.Continue Reading 501(c)(4) Organizations Could Face Additional Scrutiny Following Court Decision