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What to Do If You Receive a Letter About Having to Pay Back PRF Funds: A Guide for Healthcare Providers


The Provider Relief Fund (PRF) has been a lifeline for healthcare providers throughout the COVID-19 pandemic. These funds were distributed to support healthcare organizations in their efforts to combat the public health emergency. However, some healthcare providers may find themselves in a situation where they receive a letter stating that they must pay back PRF funds. In this blog, we will provide a comprehensive guide on what healthcare providers should do if they receive such a letter. It is crucial to navigate this process with caution, transparency, and a strategic approach to ensure that your organization remains in compliance and to minimize the financial impact on your organization.

Review the Letter Carefully

When you receive a letter notifying you of the need to pay back PRF funds, the first step is to review it carefully. Pay close attention to the details, including the amount you are required to pay back, the reasons for the payback, and any deadlines or specific instructions mentioned in the letter.

Seek Professional Guidance

It is highly advisable that you seek support from legal or reimbursement experts who specialize in healthcare regulations and the PRF program. They can help you understand the basis for the payback request and evaluate whether it is valid or if there are grounds for appeal. These professionals can guide you through the process and help protect your organization's interests.

Gather Documentation

Collect all relevant documentation related to your use of PRF funds. This should include records of expenditures, invoices, receipts, and any other documents that demonstrate how the funds were spent. Proper documentation can be essential in resolving payback disputes. Remember that the funds need to fall into one of the following use categories: Prevent, Prepare, Respond. In addition, compile the necessary documentation to support your explanation for not completing the submission by the applicable deadline date. The Health Resources & Services Administration (HRSA) allows recipients to request an opportunity to complete their report after the reporting deadline if certain “extenuating circumstances” were present at the time of the deadline.

Communicate with the Appropriate Authority

After reviewing the letter and gathering documentation, it is important to initiate communication with HRSA through the submission of a Request to Report Late Due to Extenuating Circumstances Form. Included in the form will be a detailed explanation of the applicable extenuating circumstances that resulted in the untimely submission. The explanation should be specific and concise. If you have any concerns, it would be beneficial to contract with a PRF expert who can manage these communications with you or on your behalf.

Complete PRF Portal Submission

If HRSA approves your Request to Report Late Due to Extenuating Circumstances, you will have a prescribed window to complete your PRF Reporting Period submission. In the submission, you will be required to report on the financial and facility metrics for your entity during the applicable Period of Availability. Included in the financial data will be a detailed analysis of the expenses and lost revenues attributed to the COVID-19 pandemic. These amounts will be compared to the PRF payments received to determine whether any excess payments need to be returned to HRSA. If you have any issues compiling the necessary data, it would be beneficial to contract with a PRF expert who can provide assistance with the calculations and analysis.

Appeal if Applicable

If your Request to Report Late Due to Extenuating Circumstances is denied, consider filing an appeal. Healthcare providers have the right to appeal PRF payback determinations. Legal and reimbursement experts can guide you through this process and help build a strong case for your appeal.

Develop a Financial Strategy

If it becomes evident that you will need to pay back PRF funds, it is essential to develop a financial strategy. Work closely with your financial team to assess the impact on your organization's budget and operations. Consider how you will manage the repayment without compromising your healthcare services.


Though your initial response when receiving a letter about paying back PRF may be to send back the funds, there are steps that you can take to protect the finances of your organization. With careful review, expert guidance, transparent communication, and a strategic approach, you can effectively navigate this challenge. Remember that the PRF program is complex, and mistakes can happen, but with the right support and diligence, you can work toward a resolution that minimizes the financial impact on your organization.

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