There is a new provision in the Affordable Care Act that establishes penalties for tax exempt hospitals related to insufficient amounts of Charity Care. Hospitals are now required to file additional paperwork every three years with the IRS to demonstrate that we are worthy of their tax exempt status through the provision of Charity Care. Failure to demonstrate a continuing need could result in a loss of tax exempt status. Such hospitals would then be forced to become for-profit hospitals requiring each to pay taxes. Some are saying the bar will be set very high for tax exempt hospitals to achieve the new IRS standards so additional tax paying entities can be created. It is also being stated the new provision will also lead to a single payer system for health care; a rumored goal of the current administration since introducing the new law. If hospitals fail to meet the new standards they could be fined $50,000 and become tax paying entities. At this point, the best advice for not-for-profit hospitals is to do as much as you can related to your fulfillment of community benefit, especially Charity Care, and hope for the best. At WMHS, we have been dramatically increasing our community benefit contributions that resulted in just under $40 million in 2012. Going forward we will also provide care through our various clinics at no charge to the patient. This will greatly aid our health care reform initiatives, but also better satisfy our community benefit requirements in the year to come.