Application Review Process

After a provider submits their application, it undergoes an initial review by HRSA.

ARP Rural and Phase 4

Duplicate Applications

HRSA will review all applications and identify those that are duplicates.

Phase 4 Only

New providers in 2019 or 2020

HRSA will identify applicants that began delivering patient care for the first time during the period of January 1, 2019 to December 31, 2020 and:

• Imputes quarterly losses net expenses based on the mean loss ratio for their provider type.
• Imputes annual patient care revenues as sum of the applicant’s quarterly revenues, for applications without a full year of revenues.

Pharmacy and Durable Medical Equipment (DME) Suppliers

HRSA will identify pharmacies and DME suppliers and cap their annual revenues from patient care at 10% of their total annual revenue.

Financial information

HRSA will identify applicants with reported financial data that is anomalous or outside the expected range, and with potentially high payments. HHS will conduct an in-depth manual review of the application and supporting documentation for responsiveness:

• If HRSA determines that the application is fully supported by the documentation, then payment will be based on the submitted figures.

• If HRSA determines that the application is insufficient based on review of the supporting documentation, then no payment will be issued.

• If HRSA determines that the application is reasonable but not fully supported by the supporting documentation, then payment will be based on loss ratios.