Third Party Authorization

If you are a health care provider (HCP) participating in the HCF or Telecom Program, and a consultant or other third party (i.e., anyone who is not employed by the HCP) will file forms on behalf of your site, you will need to file a third party authorization (TPA). A TPA provides written authorization to the third party to complete and submit forms on behalf of the HCP or consortium in the HCF Program or Telecommunications Program.

Download a sample TPA.

Requirements

A TPA must include:

• The name and contact information (mailing address, phone number, and email address) of the third party authorized to submit forms on behalf of the HCP;
• A statement by the third party that the applicant accepts any and all potential liability for applicable RHC program rule violations and any errors, omissions, or misrepresentations on the forms or documents submitted by the third party;
• Specific timeframe the TPA covers (i.e., start date and end date);
• A signature of an officer, director, or authorized employee of the HCP (could be an officer, director, or other authorized employee of the HCP or consortium);
• The signature date;
• Statement identifying which RHC program(s) the TPA covers (i.e., the HCF Program, Telecommunications Program, or both);
• Consortia only: A statement that the TPA is for the purpose of filing forms and documentation on behalf of the consortium for the life of the authorization; and
• A list of HCP sites the TPA covers, including the HCP number, name, and address for each site.

USAC recommends following these same guidelines when submitting a TPA for the Telecom Program.

Recommendations

The duration of the authorization is at the discretion of the HCP and the third party. USAC recommends that the TPA cover a minimum of twelve months or a period long enough to include the invoice filing deadline (for the HCF Program).

Things to Know

• If the third party files the FCC Form 460 (Eligibility and Registration Form) or FCC Form 465 (Description of Services Requested and Certification Form), they must upload the TPA at the time of the filing.
• A third party is defined as any individual who is not an officer, director, or authorized employee of the HCP, and may include a consultant, contractor, or attorney.
• Consortia only: Separate TPAs are not required between consortium members and third parties, as long as the letter of agency (LOA) between the consortium members and consortium leader contains language that specifies that the consortium leader and its agents are authorized to act on behalf of the consortium members to submit their forms.

 

The material on these webpages is provided for general information only and should not be relied upon or used as the sole basis for making decisions without consulting the RHC program rules, orders, and other primary sources of information. Applicants and service providers are ultimately responsible for knowing and complying with all RHC program rules and procedures.