Rural Health Care

Glossary of Terms

Below are terms that will help participants in understanding the Rural Health Care Program and its application process.

28-day Posting Period: This is the competitive bidding period that begins when the Description of Services Requested & Certification Form (FCC Form 465) is posted on the USAC website, and allows for service providers to contact health care providers (HCPs) to discuss service needs and to submit proposals for those needs. An HCP may not sign a contract or enter into an agreement for services before the end of the 28-day posting period -- it must wait until day 29. An HCP that enters into an agreement before completing the 28-day posting requirement will be in violation of the FCC's competitive bidding rules for this program and may not receive support for that fund year.

Billed Entity: The entity that receives the bill and pays for the HCP's supported service. The billed entity may be different from the health care provider location being supported.

Billing Account Number: Telephone number or customer account code associated with the service supported by USAC. Each Billing Account Number is attached to a customer (billed entity).

E-Certification (E-Cert): Process that allows applicants to certify and submit forms online, eliminating the need for a paper form with an original signature.

Eligible Health Care Provider: As explained by the FCC's Rural Health Care Order adopted November 13, 2003, Public and not-for-profit HCPs eligible for this program include:

  • Post-secondary educational institutions offering health care instruction, teaching hospitals, and medical schools
  • Community health centers or health centers providing health care to migrants
  • Local health departments or agencies
  • Community mental health centers
  • Not-for-profit hospitals
  • Rural health clinics
  • Consortia of health care providers consisting of rural for-profit hospitals
  • Dedicated emergency departments of rural for-profit hospitals
  • Part-time eligible entities located in facilities that are ineligible

Evergreen Contracts: Most applicants to the Rural Health Care Program have contracts. For an applicant to be considered under contract, the contract must identify both parties to the contract, be signed and dated by both parties to the contract, specify the type and terms of service, have a specific duration, and be reviewed and verified as to these details by USAC. Applicants that present such contracts will be considered to have "evergreen" status, meaning that for the life of the contract (without any optional extension), they need not re-compete the service or post an FCC Form 465, and may annually apply for support of the contracted service by filing the Funding Request and Certification Form (Form 466) and/or the Internet Service Funding Request and Certification Form (Form 466-A). USAC reviews all submitted contracts, determines if they qualify for evergreen status, and logs the contract end date into the applicant's file.

If an HCP submits a contract that does not meet these FCC requirements for a contract, it is considered to have month-to-month, tariffed service and must post an FCC Form 465 and select the most cost-effective service and service provider each year. Support for a month-to-month service cannot start before the completion of the 28-day posting period and the cost of a service termination should not be a consideration in determining the most cost-effective service. The contract status of applicants is indicated in their Funding Commitment Letter, which shows "contract" for applicants with evergreen contract status or "tariff" for applicants not considered to be under contract.

Applicants whose contracts have evergreen status are reminded to post and FCC Form 465 and re-compete and select a service provider before the life of the contract ends. An optional contract renewal counts as a new contract and must be selected through posting a Form 465. Evergreen contract applicants that post a Form 465 should advise any bidders of their contract end date and if it is after the end of the fund year should indicate that in their Form 465 service needs description. Applicants are reminded that a new FCC Form 465 must be posted if additional services not included in the original contract are added. The FCC Form 465 containing any new services must be posted for 28-days and the most cost-effective bid should be chosen.

Evidence for Rural Rate: For FCC Form 466, the telecommunications carrier or the HCP must provide supporting evidence for the rural rate (see definition below). Evidence may include telephone bills, signed and dated statements on letterhead from an eligible telecommunications carrier, invoices, or contracts that show services and charges for the rural rate. Include summary pages where possible, and textual explanations as necessary for USAC to substantiate the claimed rural rate. Always include the HCP Number and name.

Evidence for Urban Rate: For FCC Form 466, the telecommunications carrier or the HCP must provide supporting evidence for the urban rate (see definition below). As a service to applicants, USAC has obtained the urban rates for the most common services in large cities across the country, calculated using tariffs filed by telecommunications carriers. Taxes are not included. Evidence may include (but is not limited to) telephone bills, invoices, tariff pages, a letter from the urban telecommunications carrier, or rate pricing information provided on the urban carrier's website that show services and charges for the urban rate. Include summary pages where possible, and textual explanations as necessary for USAC to verify the claimed urban rate. Always include the HCP Number and name.

FCC Registration Number (FCC RN): Number issued by the FCC for participation in the Rural Health Care Program. Information on how to get an FCC RN is available on the FCC website (www.fcc.gov) under the "FCC Registration Number (FRN) Commission Registration System (CORES)" link on the left side.

FCC Form 465: Description of Services Requested & Certification Form. Form completed by the HCP to request services and establish eligibility. After the form is approved and processed by USAC, it is posted on the USAC website for potential bidders to review.

FCC Form 466: Funding Request and Certification Form. Form completed by the HCP to identify the service and telecommunications carrier. The applicant must send this form and billing documentation to USAC after it has selected a service provider. The applicant must submit one Form 466 for each service for which support is sought.

FCC Form 466-A: Internet Service Funding Request and Certification Form. Form used by the HCP and its authorized representatives to request support for reduced Internet service rates. The applicant must submit one Form 466-A for each Internet service provider. The FCC, in its Order adopted December 15, 2004, determined that entirely rural insular areas (currently identified as American Samoa, U.S. Virgin Islands, the Commonwealth of the Northern Marianas Islands, and Guam) must request support for both telecommunications and Internet services using Form 466-A.

FCC Form 467: Connection Certification Form. Form completed by health care provider after the service starts. It allows the applicant to identify and/or modify the actual service start and actual end of service dates for the supported service. A Form 467 must be completed prior to receiving support.

Funding Commitment Letter (FCL): Letter sent to the HCP (with a copy to the service provider) after USAC approves a "packet" (FCC Form 466 and/or 466-A, and applicable attachments). The letter notifies the HCP that the service will be supported contingent upon the completion of an FCC Form 467. The letter also estimates the support amount for the funding year based on the number of months the service is expected to be in place. Once an HCP receives the Funding Commitment Letter, a Form 467 must be completed and returned to USAC before support begins.

Funding Request Number (FRN) (formerly Work Order Number): Number assigned by USAC for unique combination of health care provider (HCP), service provider, and service. The FRN is listed on the Funding Commitment Letter and HCP support schedule.

Funding Year: The first funding year for the Rural Health Care Program started on January 1, 1998 and ended June 30, 1999 (18 months). All subsequent Funding Years begin July 1 and end June 30 of the following year. For example, FY2003 began July 1, 2003 and ended June 30, 2004.

Health Care Provider (HCP): Entity seeking support for telecommunications and/or Internet services under the Rural Health Care Program.

Internet Service Provider (ISP): Company that provides Internet access service. Also referred to as a service provider.

Invoice: Statement that the service provider sends after it provides support to the health care provider. Invoices must follow formatting and content guidelines provided by USAC.

Invoice Status Report: Report generated by USAC and sent to service providers indicating whether each invoice line item was approved or denied.

HCP Support Schedule: Schedule of support by month for the Funding Year provided by USAC to service providers and health care providers (HCP) after an FCC Form 467 is approved. Once a service provider receives the HCP support schedule, the service provider begins providing support.

Largest City: The largest city in the same state as the health care provider is used to determine the urban rate and maximum allowable distance (MAD -see definition below) for a given service.

Maximum Allowable Distance (MAD): The distance from the health care provider, in whole miles, to the far side of the largest city in the HCP's state. The MAD is the maximum distance for which USAC will support a telecommunications service. The MAD is listed on the FCC Form 465 posted on the USAC website. (See Quick Links or Service Provider Area - Search Postings to review posted Form 465s.)

Mileage-Based Charges (also called distance-sensitive charges or monthly mileage charges): Charges for a telecommunications service that are based on the circuit distance. Mileage-based charges typically exist for interoffice channels, and in some cases for local channels. If there are no mileage-based charges (such as for ISDN), this number is zero. Mileage-based charges should include any taxes that are applied as a percentage of the per-mile charge, but should not include taxes, surcharges, non-recurring (set-up) charges, or other fixed charges such as channel terminations, that are not mileage sensitive. If carriers use banded mileage rates (where the rate varies by circuit length, for example $50 for the first half mile and $20 for subsequent miles), the entire mileage-based charge should be recorded in FCC Form 466, Block 5, and divided by the circuit mileage to yield the average per-mile rate.

Multiple-Bill Circuit: If more than one telecommunications carrier is required to complete a health care provider's circuit, and each bills separately for their share of the circuit, it is a multiple-bill (multi-bill) circuit.

Monthly Recurring Support (MRS): Monthly support for telecommunications service and Internet access under the Rural Health Care Program.

Non-Recurring Support (NRS): One-time support for installation of service under the Rural Health Care Program.

Rate Case: When an HCP seeks support for the actual charge difference between the rural and urban rates for a telecommunications service, it is called a rate case. Generally, this would be used for a non-mileage sensitive service such as Frame Relay or ISDN, if the rural rate for the service exceeds the comparable urban rate. If an HCP is seeking support for a service such as Frame Relay or ISDN, where the urban rate is not mileage sensitive, but a rural HCP must pay for a mileage sensitive interoffice channel (link extension) to complete the connection, then a rate case may be made. A rate case may also yield more support for a multiple bill mileage sensitive circuit, such as T1, if each carrier has fixed charges and an urban HCP would only pay such charges once (rather than multiple times). Note that an HCP making a rate case must provide evidence of urban and rural rates that are comparable in terms such as length and type of service, or USAC will be unable to process a rate case request.

Rural Rate: The rate charged by a telecommunications carrier for services in the rural area where the HCP is located. Applicants must provide supporting evidence for the rural rate as described under definition above for "evidence for rural rate." For a rural rate that includes a link extension, the supporting evidence must clearly distinguish between the charge for the requested service (e.g., Frame Relay) and the link extension.

Rural Health Care Program: Universal Service Fund program established for rural health care providers. Formerly called the Rural Health Care Division at USAC and before that the Rural Health Care Corporation (RHCC). On January 1, 1999, RHCC and the School and Libraries Corporation (SLC) were combined with USAC.

Service Provider: Telecommunications carrier or Internet service provider providing the supported service to an eligible health care provider.

Service Provider Identification Number (SPIN): A unique number assigned to each service provider by USAC. USAC is responsible for collecting and distributing universal service support in connection with the administration of the various universal service support mechanisms, including the Rural Health Care Program.

Standard Urban Distance (SUD): The average diameter, in whole miles, of all large cities (of at least 50,000 people) in a state. There is a single SUD for each state. USAC supports mileage charges beyond the SUD up to the maximum allowable distance (MAD). The SUD for each state is listed on the USAC website under Applicant Area - Standard Urban Distance.

Support Months: Number of months the service is supported during the funding year. Support during the first and last month is calculated by prorating the amount of support based on the number of days the service was in place during the month (e.g., five days of service in a month with 31 days will be equal to 5/31 or 0.16 months). Service months are rounded to two decimal places.

Telecommunications Carrier: Common carrier, as defined by the FCC, providing telecommunications service including interexchange carriers, wireless carriers, and competitive local exchange carriers. Also referred to as a service provider.

Universal Service Administrative Company (USAC): A not-for-profit corporation that administers the Universal Service Fund's four programs - High Cost, Low Income, Rural Health Care, and Schools and Libraries.

Universal Service Fund (USF): Fund established by Congress and implemented by the Federal Communications Commission (FCC). The USF is administered by USAC to provide affordable telecommunications services to rural health care providers, schools and libraries, low incomes consumers, and telecommunications carriers that serve high cost areas.


Last modified on 8/31/2009