How to submit a petition
Members of the public, providers, facilities, providers of air ambulance services, plans or issuers, and state regulators can petition to revoke the certification of a current certified IDR entity.
Petitioners must complete a petition form that identifies the certified IDR entity they are seeking to de-certify, and outline the reasons for this petition.
A certified IDR entity can be decertified if the Departments determine that the certified IDR entity:
- has a pattern or practice of noncompliance with any of the requirements applicable to certified IDR entities under the Federal IDR process;
- is operating in a manner that hinders the efficient and effective administration of the Federal IDR process;
- no longer meets the applicable certification standards set forth in the interim final rules under 26 CFR 54.9816–8T(e)(1), 29 CFR 2590.716–8(e)(1), and 45 CFR 149.510(e)(1);
- has committed or knowingly participated in fraudulent or abusive activities, including submission of false or fraudulent data to the Departments;
- no longer possesses the financial viability to provide dispute resolution under the Federal IDR process;
- failed to comply with requests from the Departments made as part of an audit, including submission of records; or
- is no longer fit or qualified to make payment determinations.
It’s recommended that petitioners include supporting documents when submitting their petition.
Petitioners will receive an emailed acknowledgement of the receipt of their petition within 10 business days. After review, if the petition adequately shows a failure to comply with the requirements of the No Surprises Act, the certified IDR entity will be notified that there is a credible petition to revoke its certification. The certified IDR entity will then have an opportunity to provide a response, and a final decision will be made by the Departments and shared with the petitioner.
Submit a petition by downloading and completing this form and emailing the pdf version of it to FederalIDRQuestions@cms.hhs.gov. Use the subject line: Petition to Revoke a Certified IDR Entity’s Certification
If after reviewing the above information, you would prefer to submit a complaint against a certified IDR entity, rather than petition to revoke a certified IDR entity’s certification, you can submit a complaint via email to: FederalIDRQuestions@cms.hhs.gov.
Have questions? Email us at FederalIDRQuestions@cms.hhs.gov.