Third Party Authorization
The third party authorization (TPA) provides written authorization to a third party/consultant to complete and submit forms on behalf of a health care provider (HCP) for the HCF Program.
Download a sample TPA.
The TPA must include:
- The name and contact information (mailing address, phone number, and email address) of the third party being authorized to submit application forms.
- If the HCP has participated in the RHC Program in the past, a list of all names, HCP numbers, and physical location addresses for the HCPs on whose behalf the third party is authorized to file.
- The following statement: "[Applicant] acknowledges and agrees that it is subject to all RHC Program orders, rules, and requirements promulgated by the FCC, including those set forth in 47 C.F.R. Part 54, Subparts G and H, and that funding decisions will be made by USAC as a result of representations made and information submitted by [Applicant] and [Third Party] during the application and funding process."
- A statement by the third party that the applicant accepts any and all potential liability for any errors, omissions, or misrepresentations on the forms or documents submitted by the third party.
- The specific timeframe the TPA covers (start date and end date).
- A signature of an official who is authorized to act on behalf of the third party (could be an officer, director, or other authorized employee).
- The date the TPA was signed.
- Identification of which RHC Program the authorization covers (i.e. HCF Program, Telecommunications Program, or both the HCF and Telecommunications programs).
The duration of the authorization is at the discretion of the HCP and the third party, but it is suggested that the timeframe of the TPA, at a minimum, cover a twelve month period or a timeframe long enough to accommodate the invoicing deadline (6 months from the end date of the funding commitment, unless otherwise specified).
Things to Know
- TPAs must be submitted with the FCC Form 460.
- Third parties are any individuals not employed by the HCP, and may include consultants, contractors, or attorneys.