Providers: $25.5 billion in Provider Relief Fund & American Rescue Plan rural funding is now available. Submit your application by October 26, 2021.

Federal Poverty Guidelines

Revised Poverty Guidelines were issued on February 1, 2021, by the Department of Health and Human Services. Effective April 1, 2021, the revised Poverty Guidelines must be used in making determinations of eligibility for uncompensated services. These guidelines replace the Poverty Guidelines published on January 17, 2020. Facilities certified under one of the uncompensated services compliance alternatives are not required to use these guidelines, although they are permitted to do so.

Facilities located in Puerto Rico, the U.S. Virgin Islands, American Samoa, Guam, the Republic of the Marshall Islands, the Federated States of Micronesia, the Commonwealth of the Northern Mariana Islands, and Palau are to use the poverty guidelines for the "48 Contiguous States and the District of Columbia."

The guidelines no longer include a definition of "income." However, Hill-Burton facilities are required to use the statistical definition of income previously provided in the guidelines. 

The guidelines also no longer include a definition of "family." Hill-Burton facilities are required to use either the statistical definition of family previously provided in the guidelines or formally adopt their own written definition of family. However, the definition chosen must be used consistently in determining eligibility for uncompensated services. If the facility has not established its own formal written definition of "family," it must apply the statistical definition. To avoid misunderstandings, we recommend that facilities formally establish their definition in writing in their operating procedures manual.

Date Last Reviewed:  February 2021

Compliance & Recovery

Compliance & Recovery

Waiver & Recovery

Federal Poverty Guidelines

Spanish Poverty Guidelines
(PDF - 185 KB)

Consumer Price Index

Hill-Burton English Sign
(PDF - 121 KB)

Hill-Burton Spanish Sign
(PDF - 122 KB)

Provider's Guide to the Hill-Burton Uncompensated Services Regulations* (PDF - 3.88 MB) *If you use assistive technology, you may not be able to fully access information in this file. For assistance, contact or 888-275-4772, TTY: 877-489-4772