PRB Provider Relief Fund General Information FAQ

Summary

This Health Resources & Services Administration page, under the U.S. Department of Health & Human Services, is the index for the PRB Provider Relief Fund General Information FAQ. It offers a download of all Provider Relief Fund FAQs as a PDF (672 KB). Its sections cover an overview, rejecting payments, the Provider Relief Fund terms and conditions, ARP Rural payments terms and conditions, attestation, and ownership and financial structures. Other sections cover COVID-19 vaccine distribution and administration, balance billing, publication of payment data, and calculating eligible expenses and lost revenue.

Summary drafted by a model from the document's text below and checked by script against that text before publication. It is a navigation aid, not a reading of what the document proves. Where AI is used

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PRB Provider Relief Fund General Information FAQ

Download all Provider Relief Fund FAQs (PDF - 672 KB)

Overview

Who was eligible to receive payments from the Provider Relief Fund?

Provider Relief Fund payments were disbursed via both “General” and “Targeted” Distributions.

To have been eligible for the General Distribution, a provider must have billed Medicare fee-for-service in 2019, been a known Medicaid and CHIP or dental provider and provided after January 31, 2020 diagnoses, testing, or care for individuals with possible or actual cases of COVID-19. HHS broadly views every patient as a possible case of COVID-19.

A description of the eligibility for the announced Targeted Distributions can be found here .

All providers retaining funds must have signed an attestation and accepted the Terms and Conditions associated with payment.

Updated 2/16/2024

Was this a loan or a grant that I will need to pay back?

Retention and use of these funds are subject to certain terms and conditions. If these terms and conditions are met, payments do not need to be repaid at a later date. These Terms and Conditions can be found here .

Updated 4/25/2020

Are Provider Relief Fund recipients required to notify HRSA if they have filed a bankruptcy petition?

Yes. Provider Relief Fund recipients must immediately notify HRSA about their bankruptcy petition or involvement in a bankruptcy proceeding so that the Agency may take the appropriate steps. When notifying HRSA about a bankruptcy, please include the name that the bankruptcy is filed under, the docket number, and the district where the bankruptcy is filed. You must submit this information to PRFbankruptcy@hrsa.gov . If a Provider Relief Fund recipient has filed a bankruptcy petition or is involved in a bankruptcy proceeding, federal financial obligations will be resolved in accordance with the applicable bankruptcy process, the Bankruptcy Code, and applicable non-bankruptcy federal law.

(Added 12/9/2021)

What was the Assistance Listing (AL) (formerly the Catalog of Federal Domestic Assistance (CFDA)) number for the Provider Relief Fund program?

The AL number is 93.498.

(Updated 9/29/2021)

Why would a provider not have been eligible for a General or Targeted Distribution Provider Relief Fund payment?

In order to be eligible for a payment under the Provider Relief Fund, a provider must have met the eligibility criteria for the distribution and complied with the Terms and Conditions for any previously received Provider Relief Fund payments. Additionally, a provider must not have been terminated from participation in Medicare or precluded from receiving payment through Medicare Advantage or Part D; must not have been excluded from participation in Medicare, Medicaid, and other Federal health care programs; and must not have had Medicare billing privileges revoked as determined by either the Centers for Medicare & Medicaid Services or the HHS Office of Inspector General in order to have been eligible to receive a payment under the Provider Relief Fund.

(Updated 2/16/2024)

How should providers classify the Provider Relief Fund payments in terms of revenue type for cost reports?

Please refer to CMS FAQs - PDF (PDF - 1 MB) on how Provider Relief Fund payments should be reported on cost reports.

(Updated 9/3/2020)

How can a healthcare provider find more information on the status of their Provider Relief Fund payment or application?

Providers should contact the Provider Support Line at 866-569-3522 (for TTY, dial 711), if they have questions about the status of their payment or application. When calling, providers should have ready the last four digits of the recipient's or applicant's Tax Identification Number (TIN), the name of the recipient or applicant as it appears on the most recent tax filing, the mailing address for the recipient or applicant as it appears on the most recent tax filing, and the application number (begins with either "DS" or "CR") if they have submitted an application in the Provider Relief Fund Payment Portal.

(Added 7/8/2020)

Are hospitals and health systems in all states and territories eligible for a Provider Relief Fund payment?

Yes. Hospitals and health systems in all states and territories eligible for Provider Relief Fund payments. (Updated 8/4/2020)

Can providers who have ceased operation due to the COVID-19 pandemic still receive this funding?

If a provider ceased operation as a result of the COVID-19 pandemic, they are still eligible to receive Provider Relief Fund payments so long as they provided on or after January 31, 2020, diagnoses, testing, or care for individuals with possible or actual cases of COVID-19. HHS broadly views every patient as a possible case of COVID-19, therefore, care does not have to be specific to treating COVID-19. Recipients of funding must have complied with the Terms and Conditions related to permissible uses of Provider Relief Fund payments.

In addition, if the reporting entity has ceased operation, they will still be responsible for reporting on funds received. Reporting entities must also indicate whether their business has ceased operation. If they have ceased operation, they will be required to enter the business cease date and indicate whether the business was operational on 01/01/2020.

(Updated 2/16/2024)

Were Provider Relief funds accessible in whole or in part to bankruptcy creditors and other creditors in active litigation?

Payments from the Provider Relief Fund shall not have been subject to the claims of the provider’s creditors and providers were limited in their ability to transfer Provider Relief Fund payments to their creditors. A provider may have utilized Provider Relief Fund payments to satisfy creditors’ claims, but only to the extent that such claims constitute eligible health care related expenses and lost revenues attributable to coronavirus and were made to prevent, prepare for, and respond to coronavirus, as set forth under the Terms and Conditions.

(Added 6/8/2020)

May a health care provider that received a payment from the Provider Relief Fund exclude this payment from gross income as a qualified disaster relief payment under section 139 of the Internal Revenue Code (Code)?

No. A payment to a business, even if the business is a sole proprietorship, does not qualify as a qualified disaster relief payment under section 139. The payment from the Provider Relief Fund was includible in gross income under section 61 of the Code. For more information, visit the Internal Revenue Services' website .

(Added 7/10/2020)

Was a tax-exempt health care provider subject to tax on a payment it received from the Provider Relief Fund?

Generally, no. A health care provider that was described in section 501(c) of the Code is exempt from federal income taxation under section 501(a). Nonetheless, a payment received by a tax-exempt health care provider from the Provider Relief Fund may be subject to tax under section 511 if the payment reimbursed the provider for expenses or lost revenue attributable to an unrelated trade or business as defined in section 513. For more information, visit the Internal Revenue Services' website .

(Added 7/10/2020)

Will I receive a Form 1099?

Yes, you will receive a Form 1099 if you received and retained within the calendar year 2023 a total net payment from either or both of the Provider Relief Fund and/or COVID-19 Claims Reimbursement to Health Care Providers and Facilities for Testing, Treatment, and Vaccine Administration for the Uninsured that is in excess of $600.

(Updated 2/16/2024)

When will my Form 1099 be available?

Form 1099s will be mailed by January 31, 2024. If you have previously established an account with UnitedHealth Group and elected to receive electronic copies of documents and notices, you will not receive a mailed copy.

(Updated: 12/12/2023)

Who do I contact if I have questions regarding my Form 1099?

Please call the Provider Support Line 866-569-3522 (for TTY, dial 711) for any questions you may have regarding your Form 1099. If you have questions about filing your taxes generally, seek guidance from your accountant and/or tax professional.

(Updated 2/16/2024)

Which sections of 2 CFR 300 – UNIFORM ADMINISTRATIVE REQUIREMENTS, COST PRINCIPLES, AND AUDIT REQUIREMENTS FOR HHS AWARDS are applicable to the General and Targeted Distributions of the Provider Relief Fund?

Recipients (both non-federal entities and commercial organizations) of the General and Targeted Distributions of the Provider Relief Fund are subject to 2 CFR 300 Subpart A (Acronyms and Definitions) and B (General Provisions), subsections §75.303 (Internal Controls), and §75.351-.353 (Subrecipient Monitoring and Management), and Subpart F (Audit Requirements). In addition, the terms and conditions of the PRF payments incorporate by reference the obligation of recipients to comply with the requirements to maintain appropriate financial systems at §75.302 (Financial management and standards for financial management systems) and the requirements for record retention and access at §75.361 through §75.365 (Record Retention and Access).

(Added 12/28/2020)

Rejecting Payments

How can a provider return unused Provider Relief Fund payments that it has partially spent?

Providers that have Provider Relief Fund payments that they cannot expend on allowable expenses or lost revenues attributable to coronavirus by the Period of Availability that corresponds to the Payment Received Period were required to return such funds to the federal government.

Please note regarding the return of unused funds: The instructions on ‘PRF Return of Unused Funds Portal’ explain the two-part process to return funds. There may be a delay in processing the return, especially if repaying by paper check. If you have additional questions, please call the Provider Support Line at (866) 569-3522 (for TTY, dial 711).

Period | Payment Received Period | Period of Availability for Eligible Expenses | Period of Availability for Lost Revenues | Reporting Time Period
1 | April 10, 2020, to June 30, 2020 | January 1, 2020, to June 30, 2021 | January 1, 2020, to June 30, 2021 | July 1, 2021, to September 30, 2021
2 | July 1, 2020, to December 31, 2020 | January 1, 2020, to December 31, 2021 | January 1, 2020, to December 31, 2021 | January 1, 2022, to March 31, 2022
3 | January 1, 2021, to June 30, 2021 | January 1, 2020, to June 30, 2022 | January 1, 2020, to June 30, 2022 | July 1, 2022, to September 30, 2022
4 | July 1, 2021, to December 31, 2021 | January 1, 2020, to December 31, 2022 | January 1, 2020, to December 31, 2022 | January 1, 2023, to March 31, 2023
5 | January 1, 2022, to June 30, 2022 | January 1, 2020, to June 30, 2023 | January 1, 2020, to June 30, 2023 | July 1, 2023, to September 30, 2023
6 | July 1, 2022, to December 31, 2022 | January 1, 2020, to December 31, 2023 | January 1, 2020, to June 30, 2023 | January 1, 2024, to March 31, 2024
7 | January 1, 2023, to June 30, 2023 | January 1, 2020, to June 30, 2024 | January 1, 2020, to June 30, 2023 | July 1, 2024, to September 30, 2024
Period | Payment Received Period | Period of Availability for Eligible Expenses
Period 1 | April 10, 2020 to June 30, 2020 | January 1, 2020 to June 30, 2021
Period 2 | July 1, 2020 to December 31, 2020 | January 1, 2020 to December 31, 2021
Period 3 | January 1, 2021 to June 30, 2021 | January 1, 2020 to June 30, 2022
Period 4 | July 1, 2021 to December 31, 2021 | January 1, 2020 to December 31, 2022
Period 5 | January 1, 2022 to June 30, 2022 | January 1, 2020 to June 30, 2023
Period 6 | July 1, 2022 to December 31, 2022 | January 1, 2020 to December 31, 2023
Period 7 | January 1, 2023 to June 30, 2023 | January 1, 2020 to June 30, 2024
Period | Payment Received Period | Period of Availability for Lost Revenues
Period 1 | April 10, 2020 to June 30, 2020 | January 1, 2020 to June 30, 2021
Period 2 | July 1, 2020 to December 31, 2020 | January 1, 2020 to December 31, 2021
Period 3 | January 1, 2021 to June 30, 2021 | January 1, 2020 to June 30, 2022
Period 4 | July 1, 2021 to December 31, 2021 | January 1, 2020 to December 31, 2022
Period 5 | January 1, 2022 to June 30, 2022 | January 1, 2020 to June 30, 2023
Period 6 | July 1, 2022 to December 31, 2022 | January 1, 2020 to June 30, 2023
Period 7 | January 1, 2023 to June 30, 2023 | January 1, 2020 to June 30, 2023

To return any unused funds, use the Return Unused PRF Funds Portal. Instructions for returning any unused funds .

The Provider Relief Fund Terms and Conditions and applicable laws authorized HHS to audit Provider Relief Fund recipients now or in the future to ensure that program requirements are/were met. HHS is authorized to recover any Provider Relief Fund payment amounts that were made in error, exceed lost revenue or expenses due to coronavirus, or do not otherwise meet applicable legal and program requirements.

(Modified 2/16/2023)

If a provider returned a Provider Relief Fund payment to HHS, must it also return any accrued interest on the payment?

Yes, for Provider Relief Fund payments that were held in an interest-bearing account, the provider must return the accrued interest associated with the amount being returned to HHS. However, if the funds were not held in an interest-bearing account, there is no obligation for the provider to return any additional amount other than the Provider Relief fund payment being returned to HHS. HHS reserves the right to audit Provider Relief Fund recipients in the future to ensure that payments that were held in an interest-bearing account were subsequently returned with accrued interest.

To return accrued interest, visit pay.gov . On the webpage, locate "Find an agency," and select " Health and Human Services (HHS) Program Support Center HQ." Verify that the description is " PSC HQ Payment" and form number is "HHSHQ," then click continue . You will then need to complete the following steps: Step 1: Preview the form, then click "Continue." Step 2: Indicate whether you are completing on behalf of an individual or business and enter the following information. Business Name Field: Legal name of organization that received the payment Invoice or Ticket Number Field: "HHS-COVID-Interest" Contract/Agreement Number Field: Tax Identification Number (TIN) of organization or provider that received the payment Point of contact: Business contact information Payment Amount: (The payment amount must match the interest earned on the payment received.) Step 3: Verify the interest return payment amount and select to pay by ACH or debit/credit card, then select "Continue." Step 4: Enter the required information to complete the payment, then select "Review and Submit." Step 5: Ensure that all information is correct and select "Submit."

(Updated 12/11/2020)

If a provider rejected a payment and the associated Terms and Conditions in the attestation portal but decided to keep the funds after rejecting it in the attestation portal, what should the provider have done in order to report on the use of funds kept?

Providers who rejected one or more Provider Relief Fund and/or ARP Rural payments exceeding $10,000, in aggregate, and kept the funds were required to report on these funds during the applicable reporting period per the Terms and Conditions associated with the payment(s). In order to be able to report on the use of funds, a provider must have contacted the Provider Support Line at (866) 569-3522 (for TTY, dial 711) to request a change to their attestation from “rejected” to “accepted.” Once the attestation status has been updated in the attestation portal, the Provider Relief Fund Reporting Portal will subsequently be updated to accurately reflect the kept payment that the provider was required to report on during the applicable reporting period.

(Modified 10/27/2022)

How can I return a payment I received under the Provider Relief Fund?

If you received an invoice from the U.S. Department of Treasury Centralized Receivables Service or Cross-Servicing, please refer to the payment options found in your invoice. For more information visit the Returning Funds page .

Returning PRF or ARP Rural payments is a two-part process:

- Complete an online form via the Repayment Portal
- Once completed, you will automatically be redirected to Pay.gov .
- Transfer the funds via Pay.gov .

Click on instructions on how to complete the Repayment Form (PDF - 485 KB) for guidance.

If your organization has been referred for debt collection, refer to the payment options found in your invoice from the U.S. Department of Treasury Centralized Receivables Service (CRS), Centralized Receivables Service. Do not return payments to HRSA or United Health Group via pay.gov or check.

Learn more about returning Provider Relief Fund payments .

(Updated 9/16/2025)

If a provider rejected the payment in the attestation portal but did not return the payment within 15 calendar days, was the provider still subject to the Terms and Conditions?

Yes. If the provider did not return the payment within 15 calendar days of rejecting the payment in the attestation portal, the provider would have been considered to have accepted the payment and must abide by the Terms and Conditions associated with the distribution. The government may pursue collection activity to collect the unreturned payment.

(Added 8/30/2021)

How should a provider return a payment it received via check?

If the provider received a payment via check and had not yet deposited it, destroy, shred, or securely dispose of it. If the provider had already deposited the check, mail a refund check for the full amount, payable to “UnitedHealth Group” to the address below via United States Postal Service (USPS); mailing services such as FedEx and UPS cannot be used with this PO box. Please list the check number from the original Provider Relief Fund check in the memo. Mail a refund check for the full amount payable to “UnitedHealth Group” to the address below.

UnitedHealth Group Attention: Provider Relief Fund PO Box 31376 Salt Lake City, UT 84131-0376

(Updated 10/28/2020)

How did a provider who received an electronic payment return funding if their financial institution did not allow them to return the payment electronically?

Contact UnitedHealth Group's Provider Support Line at (866) 569-3522 (for TTY, dial 711).

(Added 5/12/2020)

If I changed my mind after I rejected a Provider Relief Fund payment through one of the attestation portals and returned the payment, can I receive a new payment?

No, HHS will not issue a new payment to a provider that received and then subsequently rejected and returned the original payment. The provider may be considered for future distributions if it meets the eligibility criteria for that distribution.

(Updated 10/28/2020)

Provider Relief Fund Terms and Conditions

What financial transactions are Reporting Entities required to report in order to satisfy the requirement in the Terms and Conditions for Phase 4 that recipients must notify HHS of a merger with or acquisition of any other health care provider during the Payment Received Period within the Reporting Time Period?

The Terms and Conditions for Phase 4 required that recipients that received payments greater than $10,000 notify HHS during the applicable Reporting Time Period of any mergers with or acquisitions of any other health care provider that occurred within the relevant Payment Received Period. HRSA considered changes in ownership, mergers/acquisitions, and consolidations to be reportable events.

(Added 12/9/2021)

If a merger or acquisition was planned before receiving Phase 4 General Distribution payments, will health care providers still need to report these activities?

If a Reporting Entity that received a Phase 4 General Distribution payment underwent a merger or acquisition during the Payment Received Period, as described in the Post-Payment Notice of Reporting Requirements (PDF) , the Reporting Entity must report the merger or acquisition during the applicable Reporting Time Period.

(Updated 12/9/2021)

What type of review will HRSA do after a merger or acquisition has been reported by recipients of a Phase 4 General Distribution payment?

If a Reporting Entity that received a Phase 4 General payment indicates when they report on the use of funds that they have undergone a merger or acquisition during the applicable Payment Received Period, this information will be a component that is factored into whether an entity is audited.

(Updated 12/9/2021)

Does HHS intend to recover any payments made to providers not associated with specific claims for reimbursement, such as the General or Targeted Distribution payments?

The Provider Relief Fund Terms and Conditions required that recipients be able to demonstrate that lost revenues or expenses attributable to coronavirus, excluding expenses and losses that have been reimbursed from other sources or that other sources are obligated to reimburse, meet or exceed total payments from the Provider Relief Fund. Provider Relief Fund payment amounts that have not been fully expended on health care expenses or lost revenues attributable to coronavirus by the deadline to use funds that corresponds to the Payment Received Period must be returned to HHS. The Provider Relief Fund Terms and Conditions and applicable legal requirements authorized HHS to audit Provider Relief Fund recipients now or in the future to ensure that program requirements are met. Provider Relief Fund payments that were made incorrectly, or exceed lost revenues or expenses due to coronavirus, or do not otherwise meet applicable legal and program requirements must be returned to HHS, and HHS is authorized to recover these funds.

(Updated 10/20/2021)

What should providers do if they had remaining Provider Relief Fund payments that they cannot expend on allowable expenses or lost revenues by the relevant deadline?

Providers that had Provider Relief Fund payments that they cannot expend on allowable expenses or lost revenues by the deadline to use funds that corresponds to the Payment Received Period, as outlined in the Post-Payment Notice of Reporting Requirements, will return this money to HHS. The Provider Relief Fund Terms and Conditions and legal requirements authorize HHS to audit Provider Relief Fund recipients now or in the future to ensure that program requirements are met. HHS is authorized to recover any Provider Relief Fund amounts that were made incorrectly or exceed lost revenues or expenses due to coronavirus, or do not otherwise meet applicable legal and program requirements.

(Updated 10/20/2021)

What oversight and enforcement mechanisms did HHS use to ensure providers meet the Terms and Conditions of the Provider Relief Fund?

Providers receiving payments from the Provider Relief Fund must comply with the Terms and Conditions and applicable legal and program requirements. Failure by a provider that received a payment to comply with any term or condition can result in action by HHS to recover some or all of the payment. Per the Terms and Conditions, all recipients were required to submit documents to substantiate that these funds were used for health care-related expenses or lost revenues attributable to coronavirus, and that those expenses or lost revenues were not reimbursed from other sources and other sources were not obligated to reimburse them. HHS monitored the funds distributed, and oversaw payments to ensure that Federal dollars were used in accordance with applicable legal and program requirements. In addition, the HHS Office of the Inspector General fights fraud, waste and abuse in HHS programs, and may review these payments.

(Updated 10/20/2021)

What if my payment was greater than expected or received in error?

If HHS identified a payment made incorrectly, HHS recovered the amount paid incorrectly or overpaid. If a provider received a payment that was greater than expected and believed the payment was made incorrectly, the provider should contact the Provider Support Line at (866) 569-3522 (for TYY, dial 711) and seek clarification.

(Updated 10/14/2021)

Certain recipients were required to notify HHS of a merger with or acquisition of any other health care provider during the Payment Received Period (as defined in the Provider Relief Fund Post Payment Notice of Reporting Requirements). How should recipients have reported this information to HHS/HRSA?

To streamline the process and minimize provider burden, this information was collected in the Provider Relief Fund Reporting Portal as part of the regular reporting process. Additional reporting information will be forthcoming for impacted providers.

(Added 9/29/2021)

If a provider cannot expend its Provider Relief Fund payment by the applicable deadline to use funds, what was the deadline to return the unused funds to the government?

The provider must return any unused funds to the government within 30 calendar days after the end of the applicable Reporting Time Period or any associated grace period.

(Updated 9/29/2021)

Was there a set period of time in which providers must use the payments to cover allowable expenses or lost revenues attributable to COVID-19?

Yes. PRF and ARP Rural recipients must use payments for eligible expenses, including services rendered during the period of availability, as outlined in Table 1 below. PRF and ARP Rural recipients may also use payments for lost revenues attributable to COVID-19 incurred within the period of availability, but only up to June 30, 2023, the end of the quarter in which the COVID-19 Public Health Emergency ends.

The period of availability of funds was based on the date the payment was received. The payment was received on the deposit date for automated clearing house (ACH) payments or the check cashed date. Providers must follow their basis of accounting (e.g., cash, accrual, or modified accrual) to determine expenses.

Period | Payment Received Period | Period of Availability for Eligible Expenses | Period of Availability for Lost Revenues | Reporting Time Period
1 | April 10, 2020, to June 30, 2020 | January 1, 2020, to June 30, 2021 | January 1, 2020, to June 30, 2021 | July 1, 2021, to September 30, 2021
2 | July 1, 2020, to December 31, 2020 | January 1, 2020, to December 31, 2021 | January 1, 2020, to December 31, 2021 | January 1, 2022, to March 31, 2022
3 | January 1, 2021, to June 30, 2021 | January 1, 2020, to June 30, 2022 | January 1, 2020, to June 30, 2022 | July 1, 2022, to September 30, 2022
4 | July 1, 2021, to December 31, 2021 | January 1, 2020, to December 31, 2022 | January 1, 2020, to December 31, 2022 | January 1, 2023, to March 31, 2023
5 | January 1, 2022, to June 30, 2022 | January 1, 2020, to June 30, 2023 | January 1, 2020, to June 30, 2023 | July 1, 2023, to September 30, 2023
6 | July 1, 2022, to December 31, 2022 | January 1, 2020, to December 31, 2023 | January 1, 2020, to June 30, 2023 | January 1, 2024, to March 31, 2024
7 | January 1, 2023, to June 30, 2023 | January 1, 2020, to June 30, 2024 | January 1, 2020, to June 30, 2023 | July 1, 2024, to September 30, 2024
Period | Payment Received Period | Period of Availability for Eligible Expenses
Period 1 | April 10, 2020 to June 30, 2020 | January 1, 2020 to June 30, 2021
Period 2 | July 1, 2020 to December 31, 2020 | January 1, 2020 to December 31, 2021
Period 3 | January 1, 2021 to June 30, 2021 | January 1, 2020 to June 30, 2022
Period 4 | July 1, 2021 to December 31, 2021 | January 1, 2020 to December 31, 2022
Period 5 | January 1, 2022 to June 30, 2022 | January 1, 2020 to June 30, 2023
Period 6 | July 1, 2022 to December 31, 2022 | January 1, 2020 to December 31, 2023
Period 7 | January 1, 2023 to June 30, 2023 | January 1, 2020 to June 30, 2024
Period | Payment Received Period | Period of Availability for Lost Revenues
Period 1 | April 10, 2020 to June 30, 2020 | January 1, 2020 to June 30, 2021
Period 2 | July 1, 2020 to December 31, 2020 | January 1, 2020 to December 31, 2021
Period 3 | January 1, 2021 to June 30, 2021 | January 1, 2020 to June 30, 2022
Period 4 | July 1, 2021 to December 31, 2021 | January 1, 2020 to December 31, 2022
Period 5 | January 1, 2022 to June 30, 2022 | January 1, 2020 to June 30, 2023
Period 6 | July 1, 2022 to December 31, 2022 | January 1, 2020 to June 30, 2023
Period 7 | January 1, 2023 to June 30, 2023 | January 1, 2020 to June 30, 2023

Provider Relief Fund recipients must use payments only for eligible expenses, including services rendered, and lost revenues attributable to coronavirus, incurred by the end of the Period of Availability that corresponded to the Payment Received Period. Providers were required to maintain supporting documentation that demonstrated that costs were incurred during the Period of Availability, as required under the Terms and Conditions. However, providers were not required to submit that documentation when reporting. Providers must promptly submit copies of such supporting documentation upon the request of the Secretary of HHS. Examples of costs incurred for an entity using accrual accounting, during the Period of Availability include:

- Services that were received
- Renovation or construction that was completed
- Tangible property ordered, but need not have been delivered

For purchases of tangible items made using PRF payments, the purchase did not need to be in the provider’s possession (i.e., back ordered PPE, ambulance, etc.) to be considered an eligible expense but the costs must have been incurred by the end of the Period of Availability. Providers must follow their basis of accounting (e.g., cash, accrual, or modified accrual) to determine expenses. For projects that are a bundle of services and purchases of tangible items that cannot be separated, such as capital projects, construction projects, or alteration and renovation projects, the project costs cannot be reimbursed using Provider Relief Fund payments unless the project was fully completed by the end of Period of Availability associated with the Payment Received Period.

Recipients may use payments for eligible expenses or lost revenues incurred prior to receipt of those payments (i.e., pre-award costs) so long as they were to prevent, prepare for, and respond to coronavirus. However, HHS expects it would be highly unusual for providers to have incurred eligible expenses or lost revenues before January 1, 2020. Additionally, the opportunity to apply Provider Relief Fund payments (excluding the Nursing Home Infection Control Distribution) and ARP Rural payments for lost revenues will be available up to June 30, 2023, the end of the quarter in which the COVID-19 Public Health Emergency ends.

HHS reserves the right to audit Provider Relief Fund recipients now or in the future, and may pursue collection activity to recover any Provider Relief Fund payment amounts that have not been supported by documentation or payments not used in a manner consistent with program requirements or applicable law. All payment recipients must have attested to the Terms and Conditions, which required maintaining documentation to substantiate that these funds were used for health care-related expenses or lost revenues attributable to coronavirus.

(Updated 2/16/2024)

Can providers use Provider Relief Fund distributions to repay payments made under the CMS Accelerated and Advance Payment (AAP) Program?

No, this was not a permissible use of Provider Relief Fund payments.

(Added 10/9/2020)

For how long are the Terms and Conditions of the Provider Relief Fund applicable?

All recipients receiving payments under the Provider Relief Fund will be required to comply with the Terms and Conditions . Some Terms and Conditions relate to the provider's use of the funds, and thus they apply until the provider has exhausted these funds. Other Terms and Conditions apply to a longer time period, for example, regarding maintaining all records pertaining to expenditures under the Provider Relief Fund payment for three years from the date of the final expenditure.

(Added 6/19/2020)

What was the definition of individuals with possible or actual cases of COVID-19?

Unless the payment was associated with specific claims for reimbursement for COVID-19 testing or treatment provided on or after February 4, 2020 to uninsured patients, under the Terms and Conditions associated with payment, providers were eligible only if they provided after January 31, 2020, diagnoses, testing or care for individuals with possible or actual cases of COVID-19. HHS broadly viewed every patient as a possible case of COVID-19.

Not every possible case of COVID-19 was a presumptive case of COVID 19.

(Added 5/6/2020)

What was the definition of Executive Level II pay level, as referenced in the Terms and Conditions?

The Terms and Conditions stated that none of the funds appropriated in this title shall be used to pay the salary of an individual, through a grant or other mechanism, at a rate in excess of Executive Level II. The salary limitation was based upon the Executive Level II of the Federal Executive Pay Scale. Effective January 5, 2020, the Executive Level II salary is $197,300. For the purposes of the salary limitation, the direct salary was exclusive of fringe benefits and indirect costs. The limitation only applied to the rate of pay charged to Provider Relief Fund payments and other HHS awards. An organization who received Provider Relief Fund payments may pay an individual’s salary amount in excess of the salary cap with non-federal funds.

(Added 5/29/2020)

ARP Rural Payments Terms and Conditions

What financial transactions were Reporting Entities required to report in order to satisfy the requirement in the Terms and Conditions for ARP Rural payments that recipients must notify HHS of a merger with or acquisition of any other health care provider during the Payment Received Period within the Reporting Time Period?

The Terms and Conditions for ARP Rural payments required that recipients that received payments greater than $10,000 notify HHS during the applicable Reporting Time Period of any mergers with or acquisitions of any other health care provider that occurred within the Payment Received Period. HRSA considered changes in ownership, mergers/acquisitions, and consolidations to be reportable events.

(Updated 12/9/2021)

If a merger or acquisition was planned before receiving ARP Rural payments, will health care providers still need to report these activities?

If a Reporting Entity that received an ARP Rural payment undergoes a merger or acquisition during the Payment Received Period, the Reporting Entity must report the merger or acquisition during the applicable Reporting Time Period.

(Updated 12/9/2021)

What type of review will HRSA do after a merger or acquisition has been reported by recipients of an ARP Rural payment?

If a Reporting Entity that received an ARP Rural payment indicates when they report on the use of funds that they have undergone a merger or acquisition during the applicable Payment Received Period, this information will be a component that is factored into whether an entity is audited.

(Updated 12/9/2021)

Can an applicant allocate ARP Rural payments to its non-rural subsidiaries?

No. As required by the Terms and Conditions, control and use of the ARP Rural payment must be delegated to the provider associated with the billing TIN that was eligible for the ARP Rural payment. The provider cannot not transfer or allocate the ARP Rural payment to another entity not associated with the billing TIN.

(Added 9/29/2021)

What can ARP Rural payment recipients use funds for?

Payment recipients must have certified that the payment was only being used to prevent, prepare for, and respond to COVID-19, and that the payment shall reimburse the Recipient only for health care related expenses or lost revenues that were attributable to coronavirus not reimbursed by other sources or that other sources are obligated to reimburse.

Lost revenues attributable to the coronavirus may include other income not derived from delivery of health care services that was customarily used to support the delivery of health care services by the recipient. Examples include, but were not limited to, decreases in tax revenue and non-federal, government grant funding. In accounting for such lost revenues, the recipient must document the historical sources and uses of these revenues. For more information about lost revenues, please review HRSA’s Lost Revenues Guide (PDF - 328 KB) .

Additionally, expenditures to prevent, prepare for, and respond to coronavirus may include those incurred expenses necessary to maintain health care delivery capacity by the recipient or to increase health care delivery capacity in the future as informed by community health needs. This may include outreach and education about the vaccine for the provider’s staff, as well as the general public.

(Added 9/29/2021)

Was there a set period of time in which providers must use ARP Rural payments to cover allowable expenses or lost revenues attributable to COVID-19?

Yes. Providers have at least 12 months, and as much as 18 months, based on the payment received date, to control and use the payments for expenses and lost revenues attributable to coronavirus incurred during the Period of Availability.

The payment was considered received on the deposit date for automated clearing house (ACH) payments, or the check cashed date for all other payments.

Period | Payment Received Period | Period of Availability for Eligible Expenses
Period 4 | July 1, 2021 to December 31, 2021 | January 1, 2020 to December 31, 2022
Period 5 | January 1, 2022 to June 30, 2022 | January 1, 2020 to June 30, 2023
Period 6 | July 1, 2022 to December 31, 2022 | January 1, 2020 to December 31, 2023
Period 7 | January 1, 2023 to June 30, 2023 | January 1, 2020 to June 30, 2024
Period | Payment Received Period | Period of Availability for Lost Revenues
Period 4 | July 1, 2021 to December 31, 2021 | January 1, 2020 to December 31, 2022
Period 5 | January 1, 2022 to June 30, 2022 | January 1, 2020 to June 30, 2023
Period 6 | July 1, 2022 to December 31, 2022 | January 1, 2020 to June 30, 2023
Period 7 | January 1, 2023 to June 30, 2023 | January 1, 2020 to June 30, 2023

ARP Rural recipients must use payments only for eligible expenses, including services rendered, and lost revenues attributable to COVID-19, incurred by the end of the Period of Availability that corresponds to the Payment Received Period. HRSA began distributing ARP Rural payments on November 23, 2021. Providers were required to maintain supporting documentation that demonstrated that costs were incurred during the Period of Availability, as required under the Terms and Conditions. However, providers were not required to submit that documentation when reporting. Providers must promptly submit copies of such supporting documentation upon the request of the Secretary of HHS. Examples of costs incurred for an entity using accrual accounting, during the Period of Availability include:

- Services that were received
- Renovation or construction that was completed
- Tangible property ordered, but need not have been delivered

For purchases of tangible items made using ARP Rural payments, the purchase did not need to be in the provider’s possession (i.e., back ordered PPE, ambulance, etc.) to be considered an eligible expense but the costs must be incurred by the end of the Period of Availability. Providers must follow their basis of accounting (e.g., cash, accrual, or modified accrual) to determine expenses. For projects that were a bundle of services and purchases of tangible items that cannot be separated, such as capital projects, construction projects, or alteration and renovation projects, the project costs cannot be reimbursed using Provider Relief Fund payments unless the project was fully completed by the end of Period of Availability associated with the Payment Received Period.

Recipients may use payments for eligible expenses or lost revenues incurred prior to receipt of those payments (i.e., pre-award costs) so long as they were to prevent, prepare for, and respond to coronavirus. Additionally, the opportunity to apply Provider Relief Fund payments (excluding the Nursing Home Infection Control Distribution) and ARP Rural payments for lost revenues were available up to June 30, 2023, the end of the quarter in which the COVID-19 Public Health Emergency ended.

HHS reserved the right to audit Provider Relief Fund recipients now or in the future, and may pursue collection activity to recover any ARP Rural payment amounts that have not been supported by documentation or payments not used in a manner consistent with program requirements or applicable law. All payment recipients must have attested to the Terms and Conditions, which required maintaining documentation to substantiate that these funds were used for health care-related expenses or lost revenues attributable to COVID-19.

(Added 5/5/2023)

Attestation

What action didoes a provider need to take after receiving a Provider Relief Fund payment?

The CARES Act required Provider Relief Fund payment recipients to meet certain terms and conditions if a provider retained a payment. If a provider chose to retain the funds, they had to attest to have met the terms and conditions of the payment. Not returning the payment within 90 days of receipt would have been viewed as acceptance of the Terms and Conditions . A provider must have attested for each of the Provider Relief Fund distributions received.

(Updated 2/16/2024)

Did the Provider Relief Fund attestation portals require payment recipients to attest that the payment amount was received?

Yes. The attestation portals required payment recipients to (1) confirm they received a payment and the specific payment amount that was received; and (2) agree to the Terms and Conditions of the payment.

(Updated 10/28/2020)

What if I attested and accepted a Provider Relief Fund payment, but would now like to reject the funds and retract my attestation?

If you affirmatively attested to a Provider Relief Fund payment already received and later wish to reject those funds and retract your attestation, you may do so by calling the provider support line at (866) 569-3522 ; for TTY dial 711. Note, HHS is posting a public list of providers and their payments once they attest to receiving the payment and agree to the Terms and Conditions .

(Added 6/3/2020)

Ownership and Financial Structures

If, as a result of the sale of a healthcare facility, the TIN that received a Provider Relief Fund payment is no longer providing health care services as of January 31, 2020, is it required to return the payment?

Yes. If, as a result of the sale of a healthcare facility, the TIN that received a Provider Relief Fund payment did not provide diagnoses, testing, or care for individuals with possible or actual cases of COVID-19 on or after January 31, 2020, the provider must reject the payment. The Provider Relief Fund Payment Attestation Portal guides providers through the attestation process to reject the attestation and return the payment to HRSA.

(Updated 7/1/2021)

Can a parent organization transfer General Distribution Provider Relief Fund payments to its subsidiaries?

Yes, a parent organization can accept and allocate General Distribution funds at its discretion to its subsidiaries, as long as the Terms and Conditions were met. Eligible health care entities, including those that were parent organizations must substantiate that these funds were used for health care-related expenses or lost revenue attributable to COVID-19, and that those expenses or losses were not reimbursed from other sources and other sources were not obligated to reimburse them.

(Updated 3/31/2021)

Can a parent organization allocate Provider Relief Fund General Distribution to subsidiaries that do not report income under their parent’s employee identification number (EIN)?

Yes, as long as the Terms and Conditions were met. The parent organization (an eligible health care entity) must substantiate that these funds were used for health care-related expenses or lost revenue attributable to COVID-19, and that those expenses or losses were not reimbursed from other sources and other sources were not obligated to reimburse them.

(Updated 3/31/2021)

Must a parent organization that received a Provider Relief Fund Targeted Distribution on behalf of a subsidiary in which it is has a direct ownership relationship remit the payment to the subsidiary?

No. The parent organization may allocate the Targeted Distribution to any of its subsidiaries that were eligible health care providers in accordance with the Consolidated Appropriations Act, 2021.

(Updated 2/16/2024)

Can a parent organization with a direct ownership relationship with a subsidiary that received a Provider Relief Fund Targeted Distribution payment control and allocate that Targeted Distribution payment among other subsidiaries that were not themselves eligible and did not receive a Targeted Distribution (i.e., Skilled Nursing Facility, Safety Net Hospital, Rural, Tribal, High Impact Area) payment?

Yes, in accordance with the Consolidated Appropriations Act, 2021. The parent organization may allocate the Targeted Distribution up to its pro rata ownership share of the subsidiary to any of its other subsidiaries that were eligible health care providers. To determine whether an entity is the parent organization, the entity must follow the methodology used to determine a subsidiary in their financial statements. If none, the entity with a majority ownership (greater than 50 percent) will be considered the parent organization.

(Updated 2/16/2024)

How should an organization currently undergoing a change in ownership to purchase a practice report revenue in its application?

Until the purchase is complete, the organization should only report current gross receipts in its application and should exclude the practice it is intending to purchase. Any changes in ownership that have not occurred should not be included in your revenue submission. Submissions must be based on the organization that exists at the time of application, not a projection of expected lost revenue from the practice that is being acquired.

(Added 5/20/2020)

COVID-19 Vaccine Distribution and Administration

If a provider administered a COVID-19 vaccine to a patient that had Medicare Part A, but not Part B, coverage, could the provider use Provider Relief Fund payments to cover the unreimbursed costs associated with vaccine administration?

Yes. The costs associated with administering a vaccine to a patient with Medicare Part A, but not Part B, coverage would be considered unreimbursed under the Provider Relief Fund, and payments could have been used to cover incurred expenses.

(Added 1/28/2021)

Could Provider Relief Fund payments have been used to support COVID-19 vaccine distribution?

Provider Relief Fund payments may be used to support expenses associated with distribution of a COVID-19 vaccine licensed or authorized by the Food and Drug Administration (FDA) that have not been reimbursed from other sources or that other sources are not obligated to reimburse. Funds may also be used ahead of an FDA-licensed or authorized vaccine becoming available. This may include using funds to purchase additional refrigerators or freezers, personnel costs to provide vaccinations, and transportation costs not otherwise reimbursed.

(Updated 1/28/2021)

Could Provider Relief Funds have been used to cover the cost of vaccination, including doses and administration fees, for Medicare, Medicaid, or CHIP beneficiaries?

In line with the Terms and Conditions, funds may not be used to reimburse expenses or losses that have been reimbursed from other sources or that other sources are obligated to reimburse, which include, but is not limited to, Medicare, Medicaid, and CHIP. If reimbursement does not cover the full expense of administering vaccines, Provider Relief Funds may be used to cover the remaining associated costs.

(Updated 12/11/2020)

Balance Billing

How would a provider know the in-network rates to be able to comply with the requirement to bill a presumptive or actual COVID-19 patient for cost-sharing at the in-network rate?

Providers accepting the Provider Relief Fund payment should submit a claim to the patient’s health insurer for their services. Most health insurers have publicly stated their commitment to reimbursing out-of-network providers that treat health plan members for COVID-19-related care at the insurer’s prevailing in-network rate. If the health insurer is not willing to do so, the out-of-network provider may seek to collect from the patient out-of-pocket expenses, including deductibles, copayments, or balance billing, in an amount that is no greater than what the patient would have otherwise been required to pay if the care had been provided by an in-network provider. Generally, HRSA expects that it would be highly unusual for providers to collect from an out-of-network presumptive or actual COVID-19 patient an amount that exceeds the individual plan out-of-pocket maximum for the calendar year.

(Updated 4/6/2022)

The Terms and Conditions require recipients to attest that for all care for a presumptive or actual case of COVID-19 the recipient will not seek to collect from the patient out-of-pocket expenses in an amount greater than what the patient would have otherwise been required to pay if the care had been provided by an in-network recipient. How should dental providers have complied with this requirement?

The prohibition on balance billing applies to "all care for a presumptive or actual case of COVID-19." A presumptive case of COVID-19 is a case where a patient's medical record documentation supports a diagnosis of COVID-19, even if the patient does not have a positive in vitro diagnostic test result in his or her medical record. Dental providers who are not caring for patients with presumptive or actual cases of COVID-19 would not be subject to this provision.

(Added 7/22/2020)

Did the Terms and Conditions for the General and Targeted Distributions require attesting to a ban on balance billing for all patients and/or all care, because “HHS broadly views every patient as a possible case of COVID-19”?

No. As set forth in the Terms and Conditions, the prohibition on balance billing applies to "all care for a presumptive or actual case of COVID-19."

(Added 5/6/2020)

The Terms and Conditions provision related to balance billing suggested that providers that provide out-of-network care to an insured, presumptive or actual COVID-19 patient can bill the patient’s insurer any amount, as long as they do not bill the patient directly. Was that correct?

The Terms and Conditions do not impose any limitations on the ability of a provider to submit a claim for payment to the patient's insurance company. However, an out-of-network provider delivering COVID-19-related care to an insured patient may not seek to collect from the patient out-of-pocket expenses, including deductibles, copayments, or balance billing, in an amount greater than what the patient would have otherwise been required to pay if the care had been provided by an in-network provider.

(Added 5/6/2020)

The Terms and Conditions require that “for all care for a presumptive or actual case of COVID-19, Recipient certifies that it will not seek to collect from the patient out-of-pocket expenses in an amount greater than what the patient would have otherwise been required to pay if the care had been provided by an in-network Recipient.” How did HHS define a presumptive case of COVID-19?

A presumptive case of COVID-19 is a case where a patient's medical record documentation supports a diagnosis of COVID-19, even if the patient does not have a positive in vitro diagnostic test result in his or her medical record.

(Updated 6/12/2020)

Publication of Payment Data

Was there a publicly available list of providers and the payments they received through the Provider Relief Fund?

HHS has posted a public list of providers and their payments once they attest to receiving the money and agree to the Terms and Conditions. All providers that received a payment from the Provider Relief Fund and retain that payment for at least 90 days without rejecting the funds are deemed to have accepted the Terms and Conditions. The amounts reflect the net of funds distributed excluding any monies that have been returned or recovered.

(Updated 2/16/2024)

What providers were included in the Provider Relief Fund data file on the CDC website?

The data that are posted in the public list represent providers that received one or more payments from the Provider Relief Fund and that have attested to receiving at least one payment and agreed to the associated Terms and Conditions.

(Updated 6/12/2020)

Why might a provider not be listed or listed with a different address than their service location?

Provider Relief Fund payments are being made to providers or groups of providers that are organized within a Tax Identification Number (TIN). The information displayed is of providers by billing TIN that have received at least one payment, which they have attested to, and the address associated with that billing TIN. Providers will not be listed if they have not yet attested to the payment terms and conditions or if they are within a larger billing entity that received payment. In addition, the address listed for the billing TIN often corresponds with the billing location (based on the Center for Medicare & Medicaid Services’ Provider Enrollment, Chain, and Ownership System (PECOS)), and may not align with the physical location of a health care practice site.

(Added 5/12/2020)

Will HHS release additional data such as provider types, payment amount per distribution, or payment recipients' NPIs on the public reporting of payments data file on the CDC website?

HHS does not have plans to include additional data fields in the public list of providers and payments.

(Added 5/12/2020)

Can a provider choose to have its payment data omitted from the Provider Relief Fund public list on the CDC’s website?

No. To ensure transparency, HHS will publish the names of payment recipients.

(Added 2/16/2024)

Calculating Eligible Expenses and Lost Revenue

In subsequent reporting periods, will Reporting Entities be able to change the lost revenues methodology used in a previous reporting period?

Yes. Reporting Entities that previously reported will be able to choose a different methodology for calculating lost revenues during Reporting Period 2 and any subsequent reporting periods. However, if the Reporting Entity decides to use a different methodology, they must then use the new methodology to calculate lost revenues for the entire period of availability. The Reporting Entity will be required to submit a justification for the change. If a Reporting Entity chooses a different methodology, lost revenues by quarter will not pre-populate from the previous reporting period. It is important to note that due to the overlapping periods of availability, if a Reporting Entity changes the method used to calculate lost revenues, the system will recalculate total lost revenues for the entire period of availability, which may impact the previously reported unreimbursed lost revenues. Please refer to the Post-Payment Notice of Reporting Requirements (PDF) for information on the three available methodologies for calculating lost revenues.

(Added 1/27/2022)

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