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Program Update

With the passage of the Fiscal Responsibility Act of 2023 and related rescission of program funds, no further payments will be made to providers under the Provider Relief Fund or the American Rescue Plan Rural Distribution, including no reconsideration payments. Likewise, no additional claims payments will be made under the Uninsured Program or Coverage Assistance Fund. Per the Terms and Conditions of each Program, all reporting and auditing requirements will continue without disruption.



“Applicant” means an individual or entity eligible to apply to Phase 4 and/or the ARP Rural Payment distributions.

Operating Revenues from Patient Care

“Operating revenues from patient care” means revenues that represent amounts received for the delivery of health care services directly to patients. Operating revenues from patient care include:

  • Revenues for patient services delivered;
  • Prescription sales revenues derived through the 340B program; and
  • Interest and depreciation on building and equipment used in the provision of patient care.

The following are not considered patient care revenues and must be excluded from the reported patient care revenues figures:

  • insurance settlements;
  • retail, or real estate revenues (exception for nursing and assisted living facilities’ real estate revenues where resident fees are allowable);
  • prescription sales revenues (exception when derived through the 340B program);
  • grants or tuition;
  • contractual adjustments from all third-party payors;
  • charity care adjustments;
  • bad debt;
  • any gains and/or losses on investments;
  • prior PRF payments received; and
  • other pandemic assistance received, including Rural Health Clinic COVID-19 Testing funds.

Operating Expenses from Patient Care

“Operating expenses from patient care” means the operating expenses incurred as part of the delivery of care, including:

  • Salaries and benefits;
  • Contracted and/or employed physicians;
  • Medical supplies; and
  • Interest and depreciations on building and equipment used in the provision of patient care.

The following are not considered patient care expenses and must be excluded from the reported patient expenses figures:

  • Any non-operating expense such as costs incurred on any rental property not used for direct patient care (e.g., nursing and assisted living facilities’ real estate costs where resident costs are allowable),
  • Contributions made; and
  • Gains and/or losses on investments.

Q1, Q3, and Q4

“Q1” refers to January 1 – March 31.

“Q3” refers to July 1 – September 30.

“Q4” refers to October 1 – December 31.

Rural Provider

“Rural Provider” refers to an applicant’s billing TIN(s) that operate in or serve patients living in the Federal Office of Rural Health Policy’s definition of a rural area, which includes: 

  1. All non-Metro counties.
  2. All Census Tracts within a Metropolitan county that have a Rural-Urban Commuting Area (RUCA) code of 4-10. The RUCA codes allow the identification of rural Census Tracts in Metropolitan counties.
  3. 132 large area census tracts with RUCA codes 2 or 3. These tracts are at least 400 square miles in area with a population density of no more than 35 people per square mile.
  4. 295 outlying Metropolitan counties with no Urbanized Area population.

Self-selected Provider Type

“Self-selected provider type” refers to the list of provider types in Field 5 Applicant Type:

  • Ancillary Services - Chiropractors
  • Ancillary Services – Dental Service Providers
  • Ancillary Services – Diagnostics (e.g., independent imaging, radiology, labs)
  • Ancillary Services – DME / Suppliers
  • Ancillary Services – Eye and Vision Service Providers
  • Ancillary Services – Pharmacy
  • Ancillary Services – Respiratory, Developmental, Rehabilitative, and Restorative Service Providers (e.g., physical therapy, occupational therapy)
  • Ancillary Services – Other Ancillary Service Providers (e.g., speech and language pathologists)
  • Emergency Medical Service Providers
  • Facilities – Acute Care Hospital
  • Facilities – Acute Care Hospital, Academic Medical Center
  • Facilities – Acute Care Hospital, Children’s Hospital
  • Facilities – Assisted Living Facilities
  • Facilities – Hospice Providers
  • Facilities – Inpatient Behavioral Health Facilities (e.g., inpatient psychiatric facilities, inpatient substance abuse treatment centers)
  • Facilities – Nursing Homes (e.g., skilled nursing facilities)
  • Facilities – Residential Treatment Facilities
  • Facilities – Other Inpatient Facilities ( e.g., inpatient rehabilitation facilities, long-term acute care hospitals, other residential facilities)
  • Home and Community – Home Health Agencies
  • Home and Community – Home and Community-based Support Providers (e.g., housing services, care navigators, case management)
  • Home and Community – Other Services (e.g., foster care, developmental disability services)
  • Outpatient and Professional – Ambulatory Surgical Center
  • Outpatient and Professional – Behavioral Health Providers (e.g., substance use disorder, counseling, psychiatric services)
  • Outpatient and Professional – Federally Qualified Health Center
  • Outpatient and Professional – Multi-specialty Practice
  • Outpatient and Professional – Pediatrics Practice
  • Outpatient and Professional – Primary Care Practice
  • Outpatient and Professional – Podiatric Medicine and Surgery Practice
  • Outpatient and Professional – Rural Health Clinic
  • Outpatient and Professional – Other Outpatient Clinic (e.g., urgent care, dialysis center)
  • Outpatient and Professional – Other Single Specialty Practice


“Subsidiary” means an entity that (i) is a disregarded entity for federal income tax purposes and (ii) reports its revenues on the applicant’s federal income tax return’s line for “gross receipts or sales” or “program service revenue.”

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