Geisinger Health Plan v. Commissioner

100 T.C. No. 26, 100 T.C. 394, 1993 U.S. Tax Ct. LEXIS 26
CourtUnited States Tax Court
DecidedMay 3, 1993
DocketDocket No. 20793-90X
StatusPublished
Cited by10 cases

This text of 100 T.C. No. 26 (Geisinger Health Plan v. Commissioner) is published on Counsel Stack Legal Research, covering United States Tax Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Geisinger Health Plan v. Commissioner, 100 T.C. No. 26, 100 T.C. 394, 1993 U.S. Tax Ct. LEXIS 26 (tax 1993).

Opinion

OPINION

Cohen, Judge:

This case is now before the Court pursuant to remand from the Court of Appeals for the Third Circuit in its opinion reversing our holding that petitioner’s health maintenance organization (HMO) is an organization described in section 501(c)(3). Unless otherwise indicated, all section references are to the Internal Revenue Code in effect at the time the petition was filed, and all Rule references are to the Tax Court Rules of Practice and Procedure.

The Court of Appeals held that petitioner Geisinger Health Plan (ghp), standing alone, is not entitled to tax-exempt status because:

it does no more than arrange for its subscribers, many of whom are medically underserved, to receive health care services from health care providers. This is so even though it has a program designed to subsidize the subscribership of those who might not be able to afford the fees required of all other subscribers. Arranging for the provision of medical services only to those who “belong” is not necessarily charitable, particularly where, as here, the HMO has arranged to subsidize only a small number of such persons. * * *

Geisinger Health Plan v. Commissioner, 985 F.2d 1210, 1220 (3d Cir. 1993), revg. T.C. Memo. 1991-649. With respect to an argument not addressed in our Memorandum Opinion, the Court of Appeals stated:

Alternatively, GHP argues that it is entitled to tax-exempt status under section 501(c)(3) because it is an integral part of the Geisinger System. The integral part doctrine provides a means by which organizations may qualify for exemption vicariously through related organizations, as long as they are engaged in activities which would be exempt if the related organizations engaged in them, and as long as those activities are furthering the exempt purposes of the related organizations. Texas Learning Technology Group v. Commissioner, 958 F.2d 122, 126 (5th Cir. 1992). The integral part doctrine has been applied in the context of several Code sections. See, e.g., Squire v. Students Book Corp., 191 F.2d 1018 (9th Cir. 1951); Brundage v. Commissioner, 54 T.C. 1468 (1970), acq. 1970-2 C.B. xix; Rev. Rul. 81-19, 1981-1 C.B. 353; Rev. Rul. 75-282, 1975-2 C.B. 201.
We decline to address the merits of the integral part doctrine at this stage, and instead remand the question of its application to this case to the Tax Court for clarification. Cf. Garden State Bar Association v. Middlesex County Ethics Committee, 687 F.2d 801, 802-03 (3d Cir. 1982). It is possible that the Tax Court, in ruling that GHP was entitled to exemption under section 501(c)(3), silently intermingled the roles played by GHP and other entities in the Geisinger System, thus effectively grounding its decision in the integral part doctrine. Its recitation of a great many facts regarding other entities in the Geisinger System suggests that it may have done just that. If that is the case, the Tax Court is in the best position to clarify this matter on remand. [Id. at 1220.]

In view of the comments and direction of the Court of Appeals, we here summarize and repeat those facts from our Memorandum Opinion most directly related to the alternative issue to be decided.

Role of Petitioner in the Geisinger System

Petitioner owned and operated a health maintenance organization (hmo) under the Pennsylvania Health Maintenance Organization Act, Pa. Stat. Ann. tit. 40, secs. 1551-1567 (Supp. 1991). Petitioner was one of nine related organizations. The eight other organizations, referred to collectively as the Geisinger system and described below, were the Geisinger Foundation (the foundation), Geisinger Medical Center (GMC), Geisinger Clinic (the clinic), Geisinger Wyoming Valley Medical Center (gwv), Marworth, Geisinger System Services (GSS), and two professional liability trusts. Each of these eight entities was recognized by the Internal Revenue Service as an exempt organization described in sections 170(b)(l)(A)(iii), 501(c)(3), and 509(a)(1).

The Geisinger system was a large health care network, the fundamental purpose of which was to provide health care services to residents of northeastern and northcentral Pennsylvania. The Geisinger system’s service area covered 27 counties with a total population of 2.1 million.

The foundation controlled petitioner and the other entities in the Geisinger system, as well as three for-profit corporations. The foundation had the power, under the articles of incorporation and bylaws of petitioner, GMC, GWV, GSS, the clinic, and Marworth, to appoint the corporate members of those entities, who in turn elected their respective boards of directors. The foundation’s board of directors was composed of civic and business leaders who were representative of the general public in northeastern and northcentral Pennsylvania and were public-spirited citizens. The foundation raised funds for the Geisinger system’s numerous charitable purposes and activities.

GMC was one of the largest rural health care facilities in the United States. It operated a 569-bed regional medical center and, as of March 31, 1988, had 3,512 employees, including 195 resident physicians and fellows in approved postgraduate training programs. GMC accepted patients without regard to their ability to pay, including Medicare, Medicaid, and charity patients. It also operated a full-time emergency room that was open to all patients, regardless of their ability to pay. In addition, GMC was a teaching hospital that had made an extensive commitment to medical education.

GWV was a 230-bed hospital located in Wilkes-Barre, Pennsylvania. GWV accepted patients without regard to their ability to pay. It also operated a full-time emergency room that was open to all persons requiring emergency treatment, regardless of their ability to pay.

The clinic was established in 1962 to engage in medical research in conjunction with GMC and employed licensed physicians who performed medical services for GMC, GWV, and other entities within the Geisinger system. As of March 31, 1988, it employed 401 physicians who worked at the clinic and at 42 other locations throughout the 27-county area serviced by the Geisinger system. The clinic accepted patients without regard to their ability to pay.

Marworth operated two alcohol detoxification and rehabilitation centers and ran educational programs to prevent alcohol and substance abuse. GSS employed management and other personnel who provided services to entities in the Geisinger system.

Article 3 of petitioner’s articles of incorporation included the following paragraphs identifying among its purposes:

A.

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Cite This Page — Counsel Stack

Bluebook (online)
100 T.C. No. 26, 100 T.C. 394, 1993 U.S. Tax Ct. LEXIS 26, Counsel Stack Legal Research, https://law.counselstack.com/opinion/geisinger-health-plan-v-commissioner-tax-1993.