View Information Collection Request (ICR) Package
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View ICR - Agency Submission
COMMENT
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Days
HR
Min
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OMB Control No:
0906-0068
ICR Reference No:
202601-0906-002
Status:
Received in OIRA
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
Date Submitted to OIRA:
01/08/2026
Requested
Previously Approved
Expiration Date
36 Months From Approved
01/31/2026
Responses
100
308,029
Time Burden (Hours)
629
1,556,212
Cost Burden (Dollars)
0
0
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
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
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
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
Number of Information Collection (IC) in this ICR:
1
IC Title
Form No.
Form Name
COVID-19 Provider Relief Fund (PRF) Reporting Activities
1
Data Form Elements
ICR Summary of Burden
Total Request
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.
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
Agency Contact:
Laura Cooper 301 443-2126 lcooper@hrsa.gov
Common Form ICR:
No
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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