OMB control number
COVID–19 Provider Relief Programs Single and Commercial Audits and Delinquent Audit Reporting Submission Activities
OMB 0906-0083 · HHS/HRSA.
HRSA will use the information for the purpose of ensuring that providers who received over $750,000 in funding from any of the Provider Relief Program combined to 1) submit an audit per 45 CFR 75 Subpart F, 2) any documentation and attestation needed to resolve any audit findings, and 3) an attestation or documentation to prove an audit is not required. If the information is not collected, HRSA will not be in compliance with 45 CFR 75 Subpart F and will limit HRSA’s ability to monitor the Federal programs. In addition, HRSA’s ability to conduct delinquent audit follow-up on appropriate entities will be jeopardized if we cannot verify who has submitted their audit. There would be a harm to the public if this collection is not approved because HRSA would be delayed in following 45 CFR 75 Subpart F and recovering federal funds not utilized in accordance with the Provider Relief Program Terms and Conditions.
The latest form for COVID–19 Provider Relief Programs Single and Commercial Audits and Delinquent Audit Reporting Submission Activities expires 2027-11-30 and can be found here.
Document Name |
|---|
Form and Instruction |
Form and Instruction |
Form and Instruction |
Form and Instruction |
Form and Instruction |
Form and Instruction |
Justification for No Material/Nonsubstantive Change |
Justification for No Material/Nonsubstantive Change |
Justification for No Material/Nonsubstantive Change |
Justification for No Material/Nonsubstantive Change |
Supplementary Document |
Supplementary Document |
Supporting Statement A |
Supporting Statement A |
| No material or nonsubstantive change to a currently approved collection | 2025-05-14 | ||
| Revision of a currently approved collection | 2024-08-15 | ||
|
Approved without change |
No material or nonsubstantive change to a currently approved collection | 2024-03-21 | |
|
Approved with change |
New collection (Request for a new OMB Control Number) | 2023-12-29 |
PRF Commercial Audit Form
Federal Enterprise Architecture: Health - Health Care Services
| Form 1 | PRF Commercial Audit Reporting Portal | Fillable Fileable | Form and instruction |
Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.