Rural Health Care

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Frequently Asked Questions

Frequently Asked Questions (FAQ's)

FAQ's are organized by subject matter. If you can't find the answer to your question, please contact Rural Health Care Division's (RHCD's) Customer Service Support Center at 1-800-229-5476

Funding Year 2007 (July 1, 2007 - June 30, 2008)
Electronic Certification
Health Care Provider (HCP) Eligibility
Service Provider Eligibility
Services Eligible for Discount
Applying for Supported Services
Forms Assistance
Calculating Support
HCP Receipt of Support
Funding Commitment Letter (FCL)
Whistleblower Hotline (Code 9 Calls)
Privacy Policy

Funding Year 2007 (July 1, 2007 - June 30, 2008)

When can I apply for support for Funding Year 2007?
RHCD begins accepting Form 465 for posting on March 12, 2007, and will continue accepting them until June 30, 2008. To ensure a full year of support, applicants should post their Form 465 before June 1, 2007.

I have submitted FCC Form 465. What do I do next?
In most cases, Form 465 MUST BE POSTED on the RHCD website for at least 28 days before an HCP may select a service provider, to be sure that all vendors interested in providing the service have an opportunity to contact the HCP. After a HCP selects a service provider, the applicant must fill out and submit FCC Form 466 and/or 466-A to provide the detailed information needed for RHCD to issue a funding commitment. Once RHCD issues a funding commitment, the HCP submits FCC Form 467 to confirm the service start date and RHCD will then arrange with the selected service provider to begin providing the discounted service.

What other documentation do I need to send in with the Form 466?

A copy of the bill, contract, or a letter from a service provider verifying the RURAL rate.
Documentation of the urban rate, if you have chosen to document your own rates instead of those provided by RHCD.
A copy of the contract signed with the service provider, if applicable.
Documentation of bids received, if you have indicated in Block 7 that you received bids.
A circuit diagram, if you have a multi-bill circuit or are a member of a large consortium.

What other documentation do I need to send in with the Form 466-A?

A copy of the bill, contract, or a letter from the Internet service provider verifying the monthly Internet access cost.
A copy of the contract signed with the service provider, if applicable.
Documentation of bids received, if you have indicated in Block 4 Line 27 that you received bids.

Where do I enter the rural rate for the urban/rural rate comparison?

This information is now located in Block 4, Line 33: "Actual Rural Rate per Month".

How do I obtain the urban rate?

The urban rate can be found in the Urban Rates Search on RHCD's web site.

Alternatively, an HCP can choose to calculate its own urban rate. An urban rate must be for a functionally similar service in any city with a population of 50,000 or more in your state, with identical terms (i.e. if the health care provider has a three-year contract, then a three-year contract rate must be used in calculating the urban rate). The circuit distance must be equal to the Standard Urban Distance for your state.

To minimize the disparity in comparing rates available in rural and urban areas, the FCC's Order of November 13, 2003 allowed HCPs to compare rates for functionally similar services as viewed from the end user's perspective. Services are considered functionally similar when operated at advertised speeds within the same category (see below) and when the nature of the service is the same (symmetrical or asymmetrical). The FCC created the following "safe harbor" categories of functionally equivalent services based on the advertised speed and nature of the service:

Low	144 - 256 kbps
Medium	257 - 768 kbps
High	769 - 1400 kbps
T-1	1.41 - 8 mbps
T-3	8.1 - 50 mbps

For more information on how to calculate urban rates, visit the " About Urban Rates" section.

How do I e-certify my form?

E-certification can be enabled simply by logging in to the RHCD website using your HCP number and password. Your "E-cert status" is shown at top. If it is enabled, the person who enabled the e-certification and the date enabled appear. If it is not yet enabled, click on the link to enable.

Once e-certification has been enabled, simply look under "Form 466/466-A Status Info". You will have the option of creating a new Form 466 using data pre-filled from the previous funding year, if you received funding in the previous year, or creating a Form 466 or 466A using a blank form.

After you have created the form, fill in the necessary information on each page, and click on "Submit". You will see a confirmation of your 466 or 466-A submission, and the contact person for that HCP number will receive an e-mail confirming that RHCD has received an e-certified Form 466 or 466-A.

Can I submit the prefilled form as it is if there are no changes?

The form requires certain information that is not pre-filled. In particular, you cannot submit the Form 466 unless the service cost per month (Block 4, Line 33) and Block 5 or Block 6 are completed. If this information is not provided, you will be unable to submit the form. Similarly, if Block 5 is not completed on Form 466A, you will not be able to submit the form.

I've electronically certified my Form 466, now what?

Please make sure to complete the process by sending RHCD the necessary documentation. Label the documents with your HCP number. (The tracking number provided in the e-mail confirming the receipt of the Form 466 or 466-A would also be helpful.)

Documentation includes:

A copy of the bill, contract, or a letter from a service provider verifying the rural rate or monthly Internet access charge.
For Form 466, documentation of the urban rate, if you have chosen to document your own rate.
A copy of the contract signed with the service provider, if applicable.
Documentation of bids received, if you have indicated in Form 466 Block 7 or in Form 466-A Block 4 Line 27 that you received bids.
For Form 466, a circuit diagram, if you have a multi-bill circuit or are a member of a large consortium.

What is acceptable documentation?

For the rural rate, RHCD will accept a copy of a telephone bill, a copy of the service agreement signed with the service provider, or a letter from the service provider on company letterhead. Any of these items must contain the health care provider's name and location, type of service, and cost.

For Internet service cost documentation, RHCD will accept a copy of the Internet access bill, a copy of the service agreement signed with the service provider, or a letter from the service provider on company letterhead. Any of these items must contain the health care provider's name, location and cost.

Documentation of the urban rate will require an explanation of how the rate was calculated. RHCD recommends viewing the guidelines for calculating urban rates.

The copy of the contract must bear two signatures, one from the service provider and the other from the health care provider.

The circuit diagram should show RHCD how the circuit(s) for the health care provider is/are connected, as well as the service provider(s) involved. Labels for the circuits (such as circuit ID and/or service type), relevant place names and addresses, and textual explanations are most helpful. Hand drawn circle and stick diagrams are acceptable if they clearly show and label the information listed above.

Does the bill have to be signed? Must it be an original copy? How recent a bill is required?

No. A photocopy of the bill will suffice. RHCD does not require that the bill bear anyone's signature. The bill must be from the current funding year.

How do I submit my documentation?

Label the documents with your HCP number and Form 466 and/or Form 466-A tracking numbers and send them to:

Rural Health Care Division
80 S. Jefferson
Whippany, NJ 07981

Is there a deadline for applications?
Forms must be received by RHCD in time to meet program year requirements. For Funding Year 2007, recommended deadlines are:

Form	Submitted By	Recommended Deadline
Form 465	HCP	05/31/2007
Form 466 and/or 466-A	HCP	07/31/2007
Form 467	HCP	10/02/2007

Although Forms 465, 466, and 466-A may be filed at any time during Funding Year 2007, all forms received by the RHCD during the Form Filing Window will be treated as if they had arrived on the same day for purposes of funding priority.

If an HCP is receiving support during Funding Year 2006, how can they ensure there will not be an interruption of support for Funding Year 2007?
In most cases, Form 465 must be posted on the RHCD website for 28 days to become eligible to receive support during Funding Year 2007. Therefore, applicants with existing service should submit their Funding Year 2007 Form 465 as soon as possible, so it can be posted for 28 days prior to the July 1, 2007 start of the funding year.

Electronic Certification

What is electronic certification?
Electronic certification is an electronic, mutually agreed-upon substitute for a person's actual, physical signature. A document signed by this method carries the same weight as one signed by hand.

What does e-certification do?
The forms used for RHCD's application process have always required submitting them on paper, bearing an original signature. E-certification allows the authorized individual to submit the form electronically with the equivalent of the person's signature on it, removing the need to send paper copies of the form. In addition, applicants who electronically certify their FCC Form 465 will automatically be posted to the RHCD website and receive electronic notification of successful posting.

Who is eligible to electronically certify?
Authorized individuals for health care providers that have successfully posted a Form 465 are eligible to e-certify.

What do I need to enable electronic certification?
To enable e-certification, an authorized individual needs the HCP number and password of the health care provider for which the e-certification will be enabled.

Where can I use electronic certification?
In RHCD's application process, all forms (465, 466, 466-A, and 467) are available for e-certification.

After I enable the electronic certification, can someone else in my office use it to submit forms online?
When you enable the electronic certification, it will be tied to both the health care provider for whom you are applying as well as the authorized individual applying on behalf of the HCP. The use of this electronic certification is the equivalent of the authorized person's actual signature for the health care provider. Since it represents the signature of an individual, no other person can use it - in the same way that a person cannot physically sign with someone else's name.

I enabled my e-certification. Now, what do I do?
Click on the "Applicants" area and go to "Applicant Login". This will allow you to log into the RHCD site to submit your form. Once logged in, you will see two options for the Form 465: "Create Form 465" and "Create Form 465 (E-Signature)". In order to submit electronically, choose the "E-Signature" option.

How will I verify that my Form 465 has been successfully submitted and posted?
The person listed as the contact on the Form 465 will receive a confirmation by e-mail verifying that the form has been received and is posted on the RHCD website. The e-mail confirmation will contain your allowable contract date, the date on which an agreement can be made with a service provider. In the event that you have no e-mail address on file, a paper confirmation will be sent to the contact mailing address. You can also verify the posting by going to the "Search Postings" area of the RHCD website.

What happens if I forget my password?
Go to the "E-Certification" section of the RHCD website and click on "Forgot My Password". You will be prompted for the verification answer you supplied when you enabled the e-certification. If the correct answer is provided, you will be shown your password.

What happens when the e-certification is disabled?
Disabling the e-certification simply removes the ability to sign and submit forms electronically. The password will remain in effect and simply function as a login password, allowing you access to the Health Care Providers area. You will be able to log in to the RHCD site to check the status of your application, fill out forms online, or change the password - however, since the electronic certification is disabled, you will be required to print out and send in the form by mail.

Once the e-certification has been disabled, can it be enabled again?
Yes. An authorized individual can go through the process again and re-enable e-certification at any time. It will be as if electronic certification is being enabled for the first time.

I enabled e-certification, so why can't I change my password in the Health Care Provider Area?
To preserve security, the electronic certification must first be disabled on the RHCD web site and re-enabled. By asking the individual to provide the information required during the enabling of e-certification, this ensures that the person attempting to change the password has the authority to do so.

HCP Eligibility

Which HCPs are eligible to receive universal service benefits?
Public or non-profit HCP's are eligible to receive discounted telecommunications services. Eligible HCP's must also be located in a rural area and fit into one of the eligible categories determined by the FCC.

Contact the Customer Service Support Center if you are unsure about eligibility.

How will an HCP determine if it is located in a rural area for purposes of eligibility?
Consult the List of Rural Areas (link) on the RHCD website.

If a nonprofit Health Maintenance Organization has its headquarters in an urban area and is billed at that urban location, but has facilities in several rural areas, would the rural facilities be eligible for support?
Yes. Each separate site or location of an HCP is considered an individual applicant, with its own HCP number, for purposes of calculating support. Therefore, each facility located in a rural area would be eligible to receive discounted services regardless of whether the headquarters is located in an urban area.

What if a telecommunications network is used for multiple purposes, some of which are not related to the provision of health care services or instruction?
Pursuant to section 54.615(c)(4) of the FCC's rules, an HCP must certify that supported service will be used solely for purposes necessary for the provision of health care or instruction. Services that are used for purposes other than health care cannot be supported. An HCP that shares supportable services with a school or library may, however, allocate the costs among the eligible entities. Form 466 and 466-A provide for HCP's to designate a percentage of their service that is shared with another entity and ineligible for Rural Health Care Program support. The Forms also allow for specifying a percentage of the HCP's service use that is not for the provision of health care, and hence, ineligible for support. [Refer to the Report and Order on Universal Service, CC Docket 96-45 (FCC 97-157, 5/7/97, paragraphs 719 & 720 regarding sharing of services.]

Service Providers Eligibility

Does a service provider have to be designated as "eligible" to receive support for serving rural HCP's?
No. The FCC's Fourteenth Order on Reconsideration (CC Docket No. 96-45, FCC 99-256, 11/3/1999) stipulated that telecommunications carriers are no longer required to be Eligible Telecommunications Carriers (ETC's) to participate in this program. All telecommunications carriers may participate, including interexchange (IXC), long-distance carriers. All Internet service providers may also participate.

Services Eligible for Discount

What services may be discounted for eligible HCP's?
Internet access charges and any telecommunications service which is used primarily for the provision of health care. These telecommunications services include, but are not limited to:

Mileage Related Charges

T3 or DS3

T1

Fractional T1

ISDN (BRI and PRI)

Frame Relay

ATM

Off-Premise Extension

Satellite Service

Centrex

Dedicated Private Line

Foreign Exchange Line

Network Reconfiguration Service

Direct Inward Dialing

Onetime (Installation) Charges

Usage and toll charges are not eligible for support. Special construction and maintenance charges are not eligible for support. Franchises, zone charges, and surcharges are also not eligible for support. Taxes, as a percentage of the cost paid on a telecommunications service, are eligible for support.

Are onetime or installation charges covered for eligible HCP's?
Yes, for telecommunications services, if there exists a difference between the charges for the same or similar services in the rural vs. the urban location and the rural is more costly, the difference is supported. For Internet access installation charges, the support is 25% of the cost of installation.

What is meant by limited distance-based charges?
Support is available for applicable distance-based charges (minus the Standard Urban Distance) for the distance between the rural HCP and the farthest point on the jurisdictional boundary of the largest city in the HCP's state. If an eligible rural HCP chooses to connect to a point beyond this Maximum Allowable Distance (MAD), it must pay the appropriate unsupported rate for any distance-based charges incurred beyond the MAD. There is no requirement, however, that the HCP choose service that connects to the largest city. The support that would have been available to the largest city may be applied to a service that connects to any other area, including in another state. Support is not available for long-distance per minute toll charges.

Is there a maximum bandwidth for eligible telecommunications services?
No. The FCC's Fifteenth Order on Reconsideration (CC Docket No. 96-45, FCC 99-269, 11/1/1999) eliminated the previous 1.544 Mbps (T-1) bandwidth limit for supportable services, starting 7/1/2000.

What Internet support is available?
For Internet access services RHCD will support 25% of the charges billed to the HCP. Use Form 466-A for this application.

Any (urban or rural) HCP that does not have toll-free access to the Internet can receive telecommunications services support: the lesser of $180 in toll charges per month or the toll charges incurred for 30 hours of access to the Internet per month. For this support, the HCP does not have to be located in a rural area, but must show that it lacks toll-free Internet access and that it is an eligible HCP. Form 466 is the appropriate form to use for this request.

What if an eligible HCP requests a service that is not offered in its local area or that could not be supported by the infrastructure or facilities currently in place? Is universal service support available for infrastructure development?
Universal service cannot support infrastructure development. In the Report and Order on Universal Service, CC Docket 96-45 (FCC 97-157, 5/7/97, the FCC stated that it had insufficient information to determine the level of need for infrastructure development or to estimate reliably the costs of supporting it. There was also insufficient information regarding existing federal and state programs already supporting infrastructure development and the extent to which such programs are meeting current needs.

Is there a limit to the number of services for which an HCP may receive support?
No. An eligible rural HCP may receive support for as many services as it can use for the provision of health care.

Can connections between two rural sites be supported?
Yes, subject to the distance limitations discussed concerning the largest city in the HCP's state, an eligible rural HCP may elect to use a supported connection to link to a site in a rural area.

Applying for Supported Services

How does the application process work?
For a detailed description, view the Process Overview description.

Will eligible HCP's receive funds from the universal service administrator to cover the cost of eligible services ordered?
No. Eligible HCP's will benefit from the universal service support mechanism through a discount on their telecommunications bills for eligible services.

Must HCP's apply for supported services each year even if they enter into a multi-year contract for the provision of services?
Yes. The FCC recognized that HCPs will often be able to negotiate better rates for multi-year contracts and encouraged HCPs to negotiate such contracts. RHCD can only commit funds to cover one year of the contract, however. HCPs must, therefore, submit an application for each funding year.

Are eligible HCP's permitted to resell the universal service supported services they receive?
No. The Act states that eligible HCPs are prohibited from reselling supported telecommunications and Internet services for money or any thing of value. This prohibition against resale does not, however, prohibit an HCP from charging normal fees for health care services, including instruction related to such services rendered via telecommunications and Internet access services purchased via the universal service mechanisms.

Forms Assistance

What forms must be filed?
Rural HCP's must file the following forms:

Form 465 - Description of Services Requested - Certifies that HCP is eligible and lists which services are being requested.
Form 466 and Form 466-A - Services Ordered and Certification - Informs RHCD of which service provider(s) and services the HCP selected and the appropriate tariff or contract pertaining the service.
Form 467 - Receipt of Service Confirmation - Informs RHCD that the service provider has begun to provide services.

How are these forms filed?
Forms 465, 466, 466-A, 467 can be completed electronically on the RHCD website. Electronic certification is available for applicants who have successfully posted a Form 465 on the RHCD website. Electronic certification allows an HCP to submit forms online by using a predetermined substitute for the authorized person's actual handwritten signature. Visit the E-Certification page for more information. Forms that are electronically submitted but not e-certed must be followed by a signed, original paper form sent to RHCD.

If not e-certed or completed online, all forms are available for download from the RHCD web site. All paper forms must be printed, signed, and mailed to RHCD before they are considered complete.

Forms should be mailed to the RHCD Customer Service Support Center at:

Rural Health Care Division
80 S. Jefferson
Whippany, NJ 07981

Who can I call if I have a question about how to fill out the forms?
Please call Customer Service Support Center at 1-800-229-5476 Monday through Friday, from 8AM to 8PM Eastern Time for help from a trained customer service representative.

Calculating Support

How is support calculated?
For telecommunications services, RHCD provides support for monthly mileage-based charges (minus the SUD) or for the difference between the rural and urban rate for non-mileage based charges. For Internet access, RHCD provides support for 25% of the HCP's Internet access charges.

How is support calculated for mileage-based charges?
Support is provided for the cost of mileage beyond the standard urban distance (urban mileage allowance for each state) up to the maximum allowable distance (MAD).

Example: A rural HCP has a dedicated T1 line from its site to an urban hospital with a circuit distance (CD) equal to 100 miles. The MAD for the rural HCP is 125 miles. The telecommunications carrier charges $10 per mile for the line. The standard urban distance (SUD) in the state is 10 miles. Support is calculated as follows:

(CD - SUD) x $/mile = Support per month

(100 miles - 10 miles) x $10/mile per month = $900 per month

How is support calculated for non-mileage based charges?
Support is provided for the difference between the rural and urban rate for all non-mileage sensitive charges.

Example: A rural HCP has an ISDN - BRI - 128 Kbps line. The telecommunications carrier charges the rural HCP as follows:
Non-recurring (installation) charge = $250
Monthly recurring charge = $175

The urban rate in the closest large city to the rural HCP is as follows:
Non-recurring (installation) charge = $150
Monthly recurring charge = $100

The rural HCP would receive a credit for the onetime non-recurring (installation) charge of $100 and monthly recurring support of $75. If service was not actually installed during the funding year, installation support would not be provided.

How is the urban rate determined?
The urban rate is the rate charged by a telecommunications carrier for the same or similar service in the largest city in the HCP's state. The urban rate should be for the same or similar term and conditions as the rural rate. The urban rate is determined by the telecommunications carrier providing the service in the urban area.

Form 466 requires that the HCP provide evidence supporting the rural and urban rate for non-mileage sensitive rates and charges. What constitutes valid evidence for the rural and urban rate?
Supporting evidence may include bills or invoices, tariff pages or a letter from the rural telecommunications carrier for the rural rate, and tariff pages, contracts, a letter from the urban telecommunications carrier, or rate pricing information provided on the urban telecommunications carrier's web-site for the urban rate. The evidence should show that like urban and rural services are being compared. Please include only summary pages where possible and please include textual explanations as necessary for RHCD to verify the claimed urban/rural difference.

If the tariffed rural rate changes during the funding year, will the support level change?
Once a rural HCP informs RHCD that they have an agreement for service (by filing Form 466), RHCD will allocate support for that service for the duration of the funding year. If tariffed or contract rates decrease, the HCP must refile Form 466, so RHCD can reduce the support level accordingly. If the tariffed or contract rates increase during the year, the HCP may re-file Form 466 to reflect the new rate. Such parties will be allocated additional support only if universal service funds remain for allocation during the funding year. Otherwise, the original support amount will be continued for the remainder of the funding year.

HCP Receipt of Support

How will HCPs receive support for their approved telecommunications service or monthly Internet access charge?
HCPs will receive support through their service provider, either as a credit to their account with their service provider or by a check issued by the service provider.

When will HCPs start to receive support?
HCPs will receive support after the service provider receives the HCP Support Schedule. The HCP Support Schedule is sent after RHCD processes Form 467.

How will HCPs know if their monthly support amount is correct?
Prior to receiving support, each HCP receives an HCP Support Schedule. The schedule provides the monthly support amounts for the funding year.

Funding Commitment Letter (FCL)

What is the FCL?
The FCL shows the amount of Universal Service Fund support that has been reserved for an applicant's discounted service. The letter is based on information provided on Forms 466 and 466-A filed with RHCD. The letter also contains information and tips that applicants will need to complete Form 467.

A final schedule of support cannot be issued until Form 467 is filed, to establish when service actually began. After receipt of Form 467, RHCD will issue an HCP Support Schedule to the applicant and service provider to verify the total support amount to be provided.

Is there any way to check on the status of an application?
Applicants may login in the Applicant Area of the website and check the status of their application or call the RHCD Customer Service Support Center at 1-800-229-5476 to check on the status of an application, if Forms 466 and 466-A have been submitted and you have not heard from RHCD. If Forms 466 and 466-A have been submitted, the Packet Status Report can help determine the status of an application.

Once Form 467 has been submitted, how soon will an HCP Support Schedule be sent?
RHCD will send HCP Support Schedules to eligible applicants and their service provider(s) as soon the Form 467 has been processed and approved by RHCD, which is generally within 3 weeks.

What if I have a question about information in the FCL?
If you have a question about information in the FCL or if the contact information that you provided has changed, please contact the RHCD Customer Service Support Center immediately at 1-800-229-5476.

Whistleblower Hotline (Code 9 Calls)

Assuring effective stewardship of the universal service support mechanism for rural health care providers by guarding against misuse or waste of universal service funds is a priority shared by USAC, the Rural Health Care Division, the FCC, applicants, service providers, and the public. To that end, the Whistleblower Hotline allows applicants, service providers, and others to alert us (anonymously, if desired) to instances where universal service funds are being misapplied or where potential program rule violations may exist.

Each call to the Whistleblower Hotline is handled by specially trained staff, and each tip is investigated carefully. If our investigation clearly confirms a program rule violation that is indicative of waste, fraud, or abuse, we will take immediate corrective steps, including but not limited to adjusting or rescinding funding commitments and recovering program funds. Other steps may be undertaken, such as referral of matters to criminal and other law enforcement agencies.

Because the RHCD treats each call to the Whistleblower Hotline as a serious and urgent matter requiring our attention, we caution you to use the hotline procedure described below ONLY to report potential instances of waste, fraud, or abuse of program rules.

Here's how the Whistleblower Hotline works:

If you want to report what you believe is a misuse of program funds or a violation of program rules, call the Customer Service Support Center at 1-800-229-5476 and tell the operator that you want to report a potential program rule violation.
You will be connected to specially trained staff who will record your report. This staff person will ask you a series of questions in order to obtain as much information about the situation as possible, so the investigation can proceed efficiently.
If you choose to remain anonymous, you may do so. If you opt to identify yourself so that our investigators can contact you for additional information, we will make every effort to maintain your confidentiality as the investigation proceeds.
After your call is complete, the report of your call will be referred to the USAC Office of General Counsel for assessment and investigation.
The USAC Office of General Counsel will make the final determination of action needed on each case, in consultation with RHCD Management and the Federal Communications Commission as appropriate.

Last modified on 6/1/2009