42 CFR Part 124, Subpart are the regulations to the Hill-Burton Act. The “Provider’s Guide to the Hill-Burton Uncompensated Services Regulations” provides guidance to grantees on how to operate an uncompensated services program in compliance with the regulations. Some grantees have been approved to operate under a compliance alternative to the hill-Burton regulations. The general Hill-Burton regulations require that grantees provide a specific amount of free or below cost health care services to persons unable to pay. The uncompensated services obligation lasts approximately 20 years for Title VI facilities and for Title XVI facilities in perpetuity.
Program Policy Notices are issued each year to grantees also providing guidance in the operation of their uncompensated services program.
The uncompensated services regulations have been amended several times to provide compliance alternatives for qualified facilities. These alternatives allow for facilities to reduce much of the procedural and reporting requirements. These facilities operate their own programs of discounted health services in lieu of operating under the general Hill-Burton requirements:
If you have questions about the operation of your uncompensated services program or would like to apply for a compliance alternative, please contact the Project Officer assigned to your grant. If you do not know the Project Officer assigned to your grant, please call 301 443-5656 or email DFCRCOMM@hrsa.gov.
In 1946, Congress passed P.L. 79-725, the Hospital Survey and Construction Act, sponsored by Senators Lister Hill and Harold Burton and widely known as the Hill-Burton Act. It was designed to provide Federal grants to modernize hospitals that had become obsolete due to lack of capital investment throughout the period of the Great Depression and World War II (1929 to 1945). Hill-Burton hospitals were required to provide uncompensated services for 20 years after receiving funds.
In 1975, Congress enacted an amendment to the Hill-Burton Program, Title XVI of the Public Health Service Act. Facilities assisted under Title XVI were required to provide uncompensated services in perpetuity. Title XVI transferred the enforcement responsibilities from States to the Federal government, and required more stringent investigation, monitoring and compliance standards. In 1979, regulations established compliance levels, eligibility, record maintenance, and reporting requirements.