COVID-19 Provider Relief Fund (PRF) and American Rescue Plan (ARP) Rural Payment Reporting Activities

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 1 Data Form Elements	Form	Modified	Available
Form 1 COVID-19 Provider Relief Fund (PRF) Reporting Activities	Form	Modified	Repair queued
PRF Reporting Activities - Post-Payment Notice of Reporting Requirements - revisions Dec 2025 12172025 Final.docx	Supplementary Document	Uploaded 2026-01-07	Available
PRF Reporting Activities - Post-Payment Notice of Reporting Requirements - revisions Dec 2025 12172025 Final.docx	Supplementary Document	Uploaded 2026-01-07	Missing upstream
Comment 1_Jean Public (07.02.2025).pdf	Public Comments	Uploaded 2025-07-02	Available
PRF Reporting Activities - Supporting Statement A - Revised 01072026.docx	Supporting Statement A	Uploaded 2026-01-07	Available
PRF Reporting Activities - Supporting Statement A - Revised 01072026.docx	Supporting Statement A	Uploaded 2026-01-07	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
250697	COVID-19 Provider Relief Fund (PRF) Reporting Activities	Form	Modified	Data Form Elements
250697	COVID-19 Provider Relief Fund (PRF) Reporting Activities	Form	Modified

ICR Details

OMB Control No: 0906-0068	ICR Reference No: 202601-0906-002
Status: Active	Previous ICR Reference No: 202305-0906-001
Agency/Subagency: HHS/HRSA	Agency Tracking No:
Title: COVID-19 Provider Relief Fund (PRF) and American Rescue Plan (ARP) Rural Payment Reporting Activities
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 04/13/2026
Retrieve Notice of Action (NOA)	Date Received in OIRA: 01/08/2026
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2029	36 Months From Approved	04/30/2026
Responses	100	0	308,029
Time Burden (Hours)	629	0	1,556,212
Cost Burden (Dollars)	0	0	0

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Abstract: HRSA disbursed the COVID-19 Provider Relief Fund (PRF) and American Rescue Plan (ARP) Rural payments to eligible health care providers to support health care-related expenses or lost revenues attributable to the COVID-19 pandemic. Recipients of PRF and ARP Rural payments agreed to a set of Terms and Conditions (T&C), which, among other requirements, mandate compliance with certain reporting requirements that facilitate appropriate oversight of recipients’ use of funds. Providers who have attested to the T&Cs regarding their PRF and ARP Rural payment(s), including the requirement that the provider "shall submit reports as the Secretary determines are needed to ensure compliance with conditions that are imposed on this Payment, and such reports shall be in such form, with such content, as specified by the Secretary in future program instructions directed to all recipients," will use the HRSA Consolidated PRF Reporting Portal to submit information about their use of PRF and ARP Rural payments. While the standard reporting time periods have ended, there are still scenarios in which providers will be required to submit reporting documents to HRSA

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Authorizing Statute(s): PL: Pub.L. 116 - 139 0 Name of Law: Paycheck Protection Program (PPP) and Health Care Enhancement Act
   PL: Pub.L. 116 - 260 M Name of Law: Coronavirus Response and Relief Supplemental Appropriations (CRRSA) Act
   PL: Pub.L. 116 - 136 0 Name of Law: The Coronavirus Aid, Relief, and Economic Security (CARES) Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 27324	06/26/2025
30-day Notice:	Federal Register Citation:	Citation Date:
	91 FR 512	01/07/2026
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
COVID-19 Provider Relief Fund (PRF) Reporting Activities	1	Data Form Elements

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	100	308,029	0	-307,929	0	0
Annual Time Burden (Hours)	629	1,556,212	0	-1,555,583	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The standard reporting time periods have ended, so only a limited number of providers are expected to submit these documents. Instead of recipients reporting once per reporting period, providers would only be providing documentation under limited circumstances, such as: • Providers who receive a Final Repayment Notice, based on a HRSA finding of reporting non-compliance, who submit a Decision Review request and are provided an Opportunity to Report. The Opportunity to Report allows providers another chance to submit a report to come into compliance. • Adjudicative orders that would require HRSA to allow a Provider an opportunity to report. • Providers who have prevailed in a dispute or have entered into a settlement with HRSA may need to submit a report.

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Annual Cost to Federal Government: $1,310,000

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Yes

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 01/08/2026

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