HHS OIG: 14 Providers Improperly Claimed $70.6M in PRF Payments

HHS OIG Reports & Publications

Published February 20th, 2026

Detected February 24th, 2026

Summary

The HHS Office of Inspector General (OIG) reported that 14 out of 30 selected Indian Health Service and rural providers did not comply with terms and conditions for expending $70.6 million in Provider Relief Fund (PRF) payments. The OIG recommended that HRSA require these providers to return unallowable expenditures.

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What changed

The HHS Office of Inspector General (OIG) has issued a report (A-09-23-01001) detailing findings from an audit of Provider Relief Fund (PRF) payments. The audit reviewed 30 selected Indian Health Service (IHS) and rural providers and found that 14 of them claimed a total of $70.6 million in unallowable expenditures. Two of these providers also had issues with calculating or supporting $19.7 million in lost revenues. These 14 providers received a combined $570.8 million in PRF payments, which were intended for COVID-19 related expenses or lost revenues.

The OIG recommends that the Health Resources and Services Administration (HRSA) require these 14 providers to return the unallowable amounts to the Federal Government or ensure they are properly replaced with eligible expenses or unreimbursed lost revenues. This finding highlights the importance of strict adherence to PRF program terms and conditions, accurate record-keeping, and proper interpretation of guidance to avoid non-compliance and potential financial repercussions. Regulated entities should review their own PRF expenditure documentation and compliance with program requirements.

What to do next

Review Provider Relief Fund (PRF) expenditure documentation for compliance with terms and conditions.
Ensure all claimed expenses and lost revenues are allowable and properly supported.
Consult HRSA guidance for correct interpretation and application of PRF requirements.

Penalties

Providers may be required to return unallowable expenditures and lost revenue amounts to the Federal Government.

Source document (simplified)

Fourteen of Thirty Selected Indian Health Service and Rural Providers Did Not Comply or May Not Have Complied With Terms and Conditions and Federal Requirements for Expending Provider Relief Fund Payments

Issued on

02/20/2026

| Posted on

02/23/2026

| Report number: A-09-23-01001

Report Materials

Why OIG Did This Audit

Congress appropriated $178 billion to HHS to provide funds to eligible providers for health care-related expenses or lost revenues attributable to COVID-19. These funds were distributed under the Provider Relief Fund (PRF) program. HHS was responsible for initial PRF program oversight and policy decisions, and HRSA administered the PRF program.
Providers receiving PRF payments were to ensure that the payments were: (1) used to prevent, prepare for, or respond to COVID-19; (2) used for health care-related expenses or lost revenues attributable to COVID-19; (3) not used to cover expenses or losses reimbursed by other funding sources; and (4) not used to pay salaries in excess of a certain threshold or to pay for certain prohibited activities.
This audit is part of a series reviewing PRF payments to various provider types. Specifically, this audit assessed whether 30 selected Indian Health Service (IHS) and rural providers expended taxpayer funds in accordance with Federal and program requirements.

What OIG Found

Of the 30 selected IHS and rural providers we reviewed, 14 providers claimed a total of $70.6 million of unallowable PRF expenditures, and 2 of those providers also inaccurately calculated or could not support $19.7 million of lost revenues. These 14 providers received a total of $570.8 million in PRF payments. The remaining 16 providers used PRF payments for allowable expenditures and lost revenues.
These deficiencies occurred because although providers attested to the PRF terms and conditions and HRSA provided continuously updated guidance to PRF recipients, some providers made clerical errors in their reporting of expenditures and did not always correctly interpret HRSA guidance or maintain documentation to support reported expenditures.

What OIG Recommends

We made three recommendations to HRSA, including that it require the selected providers to return any unallowable expenditures and lost revenue amounts to the Federal Government or ensure that the providers properly replace these unallowable expenditures with unreimbursed lost revenues or eligible expenses. The full recommendations are in the report. HRSA concurred with our recommendations.

Report Type Audit HHS Agencies Health Resources and Services Administration Issue Areas COVID-19 Departmental Operational Issues Target Groups – Financial Groups Other Funding