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LegalText 42 U.S.C. § 1320b4 Nonprofit hospital or critical access hospital philanthropy us united_states_code code_section 42 THE PUBLIC HEALTH AND WELFARE 7 SOCIAL SECURITY 1320b4 42 U.S.C. § 1320b4 current 119-100 2026-06-26 official https://uscode.house.gov/download/releasepoints/us/pl/119/100/xml_usc42@119-100.zip /us/usc/t42/s1320b4 data/legal/raw/us/code/title-42/usc42.xml 1dc65feb181e250852b2304cc4cdb027209aae3a5218073e071a81d8836ef578 644321055a08eb1f260a6a3e31ac157fa024756abf612a9fd6857e7e400cf24e 99c891a01df2df098c8fb9642ff83b20d957105ebc23561c1d0d5d5337747909 2026-07-04 official
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42 U.S.C. § 1320b4 - Nonprofit hospital or critical access hospital philanthropy

Text

For purposes of determining, under subchapters XVIII and XIX of this chapter, the reasonable costs of services provided by nonprofit hospitals or critical access hospitals, the following items shall not be deducted from the operating costs of such hospitals or critical access hospitals:

(1) A grant, gift, or endowment, or income therefrom, which is to or for such a hospital and which has not been designated by the donor for paying any specific operating costs.

(2) A grant or similar payment which is to such a hospital, which was made by a governmental entity, and which is not available under the terms of the grant or payment for use as operating funds.

(3) Those types of donor designated grants and gifts (including grants and similar payments which are made by a governmental entity), and income therefrom, which the Secretary determines, in the best interests of needed health care, should be encouraged.

(4) The proceeds from the sale or mortgage of any real estate or other capital asset of such a hospital, which real estate or asset the hospital acquired through gift or grant, if such proceeds are not available for use as operating funds under the terms of the gift or grant.

Paragraph (4) shall not apply to the recovery of the appropriate share of depreciation when gains or losses are realized from the disposal of depreciable assets.

(Aug. 14, 1935, ch. 531, title XI, § 1134, as added Pub. L. 96499, title IX, § 901(a), Dec. 5, 1980, 94 Stat. 2611; amended Pub. L. 9735, title XXI, § 2193(c)(6), Aug. 13, 1981, 95 Stat. 827; Pub. L. 97248, title I, § 137(b)(5), Sept. 3, 1982, 96 Stat. 377; Pub. L. 101239, title VI, § 6003(g)(3)(D)(iii), Dec. 19, 1989, 103 Stat. 2153; Pub. L. 10533, title IV, § 4201(c)(1), Aug. 5, 1997, 111 Stat. 373.)

Notes

Editorial Notes

Amendments1997—Pub. L. 10533 substituted “critical access” for “rural primary care” in two places in introductory provisions. 1989—Pub. L. 101239 substituted “hospitals or rural primary care hospitals” for “hospitals” in two places in introductory provisions. 1982—Par. (4). Pub. L. 97248 substituted “sale” for “scale”. 1981—Pub. L. 9735 substituted “subchapters XVIII and” for “subchapters V, XVIII, and” in provision preceding par. (1).

Statutory Notes and Related Subsidiaries

Effective Date of 1997 AmendmentAmendment by Pub. L. 10533 applicable to services furnished on or after Oct. 1, 1997, see section 4201(d) of Pub. L. 10533, set out as a note under section 1395f of this title.

Effective Date of 1982 AmendmentAmendment by Pub. L. 97248 effective as if originally included as part of this section as this section was amended by the Omnibus Budget Reconciliation Act of 1981, Pub. L. 9735, see section 137(d)(2) of Pub. L. 97248, set out as a note under section 1396a of this title.

Effective Date of 1981 Amendment, Savings, and Transitional ProvisionsFor effective date, savings, and transitional provisions relating to amendment by Pub. L. 9735, see section 2194 of Pub. L. 9735, set out as a note under section 701 of this title.

Effective DatePub. L. 96499, title IX, § 901(b), Dec. 5, 1980, 94 Stat. 2611, provided that: “The amendment made by subsection (a) [enacting this section] shall apply to grants, gifts, and endowments, and income therefrom, made or established after the date of the enactment of this Act [Dec. 5, 1980].”