Amended by section 10903 of the Manager’s Amendment. Establishes additional requirements for 501(C)(3) hospitals – applicable to each hospital separately, in the case of a multi-facility system – including conducting periodic community health needs assessments, having a financial assistance policy meeting certain criteria; implementing limitations on certain charges for those eligible for the financial assistance policy; and meeting certain billing and collection requirements. Directs Treasury to review at least once every 3 years applicable hospital organizations’ community benefit activities. Creates new reporting requirements for facilities and imposes an excise tax of $50,000 on those not adhering. Requires Treasury – in consultation with HHS – to annually report to Congress on charity care levels as well as submit a separate report on trends within 5 years. Generally effective for taxable years beginning after enactment, except for the community health needs assessment, which is effective in taxable years beginning 2 years after enactment, and the excise tax, which applies to failures occurring after enactment.