The clock is ticking on new rules under the Affordable Care Act that aim to ensure that hospitals devote more resources to charity care. But an article in the New England Journal of Medicine argues that the changes, known as Section 501(r) under the Internal Revenue Code, may not be yielding the desired effect. Section 501(r) mandates that not-for-profit hospitals must provide charity care to patients who need it—by actively ensuring that those who qualify for financial assistance get it, by charging reasonable rates to uninsured patients and by avoiding extraordinary collection practices. Hospitals also must perform a community needs assessment every three years.