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The Obama administration announced new rules under Obamacare on Monday that target nonprofit hospitals’ efforts to get paid by their patients.

Nonprofit hospitals, which serve a charitable purpose and are often religiously affiliated, will now be subject to strict rules on when and how they can collect payments from customers, thanks to regulations included in the health-care law. As a condition of their tax-exempt status, these hospitals must “take an active role in improving the health of the communities they serve,” Treasury Department deputy assistant secretary for tax policy Emily McMahon wrote in a blog post Monday.

Under the new IRS rules, the penalty for failing to meet the new standards could even lead hospitals’ tax-exempt status to be revoked entirely.

“Reports that some charitable hospitals have used aggressive debt collection practices, including allowing debt collectors to pursue collections in emergency rooms, have highlighted the need for clear rules to protect patients,” McMahon wrote. “For hospitals to be tax-exempt, they should be held to a higher standard.”

The rules cover a number of Obamacare requirements. For one, hospitals must charge the uninsured the same price for emergency care as those with insurance are “generally billed,” whether they have private coverage, Medicare or Medicaid.

Nonprofit hospitals will be required to have and “widely publicize” a financial assistance program — and will be banned from using certain collection methods until they’ve taken “reasonable efforts” to see whether a patient who hasn’t paid their bill is eligible for assistance. The hospital can’t report unpaid bills to a credit agency or garnish wages until hospital workers themselves have determined whether a customer is financially needy or is just trying to skip out on the payment.

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