OMB control number

COVID–19 Provider Relief Programs Single and Commercial Audits and Delinquent Audit Reporting Submission Activities

OMB 0906-0083 · HHS/HRSA.

OMB 0906-0083

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.

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OMB Details

PRF Commercial Audit Form

Federal Enterprise Architecture: Health - Health Care Services

Form 1PRF Commercial Audit Reporting PortalFillable FileableForm and instruction

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.