Submit CMS Public Health Emergency (PHE) Inquiry

Summary

Step-by-step quick reference for sending a Public Health Emergency inquiry to CMS through its new web system, which with very limited exception handles all 1135 waiver requests and PHE questions filed on or after January 11, 2021; Stark Law waiver requests are excluded from the portal. The user chooses the inquiry option, picks the emergency, enters contact details and a State, US Territory or Federal District, and ticks organization categories under the General, Emergency Provider/Supplier Types or Other tabs. Google Chrome or Mozilla Firefox is recommended.

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Issuer: Congressional materials
Document type: Ppr Int 9792Eef0836A46Af Phe Inquiry Pdf Fc071728D5
Case: Ppr Int 9792Eef0836A46Af Phe Inquiry Pdf Fc071728D5

Cite this document

“Submit CMS Public Health Emergency (PHE) Inquiry.” Original at www.cms.gov. Archived at Pandemic Darlings, https://pandemicdarlings.com/source-documents/ppr-int-9792eef0836a46af-phe-inquiry-pdf-fc071728d5/, SHA-256 e367f6088d712b4d065b4c0ebee4e49830468d68c48441fddb68e756798f56e7.

Full text

QUICK REFERENCE GUIDE
Submit CMS Public Health Emergency (PHE) Inquiry

With very limited exception, the new web system should be used for all 1135 waiver requests and/or
PHE-related inquiries submitted on or after January 11, 2021. Waiver requests related to the Physician
Self-Referral (Stark Law) should not be submitted via the new web portal. For these requests, please
visit: https://www.cms.gov/Medicare/Fraud-and-Abuse/PhysicianSelfReferral/Spotlight for additional
information.

Please complete all fields on the form in the order they appear, as outlined in the 4 simple
steps below.
Keyboard-only users can use the Tab key to move from field to field, the arrow keys to
navigate to the item they wish to select, and the space bar to make a selection.
A Submit button will appear at the bottom of the form once you have completed all the
required fields. Required fields are marked with (required)* following the field name.

If you need additional information about a field, hover over the question mark icon to
the right of the field.

Using either of the two recommended browsers (Google Chrome or Mozilla Firefox),
navigate to the web portal at:
CMS PHE Emergency Web Portal
Microsoft Edge and Safari are also supported browsers.
The form is also available from the CMS.gov Current Emergencies portal:
https://www.cms.gov/About-CMS/Agency-Information/Emergency/EPRO/Resources/Waivers-and-flexibilities

To Begin: Select “I want to submit an inquiry request.”
Step 1: Select the Public Health Emergency
(PHE) for which you are making a
request.
• Make a selection from the dropdown
list by clicking on the down arrow. You
can also begin typing the name of
your emergency in the field search bar
to find your Public Health Emergency.

Step 2: Provide your contact information.
• You must retype your email address in
the Confirm Email address field. The
Type. Do not copy/paste.
copy/paste tool will not work.
• Your telephone number is an optional
field, but all others are required. We
encourage you to enter your phone
number in the event there is a need to
contact you directly.

• Complete the State/US Territory/
Federal District field by selecting the
location covered by this request from
the dropdown list or by typing the
name or abbreviation for your location
in the field search bar.

• Select the Organization Categories
that best describe your organization.
Select a checkbox or checkboxes to
describe your organization from any of
the three tabs: General, Emergency
Provider/Supplier Types, or Other. At
least one checkbox is required, but
you may select multiple checkboxes.
• If you can't find an appropriate
organization category, go to the Other
tab and select the Other checkbox.
Type an organization category in the
text field that appears.
• If your entry in the Other text field
matches an existing Organization
Category, a pop-up message lets you
know that a duplicate category exists.
- If they are identical, select OK.
The system will select the
checkbox for the appropriate
existing organization category.
- If not, select Cancel and the
system accepts the text field entry.

Step 3: Describe your inquiry.
• For Inquirer Type, select from the
choices in the dropdown list by
clicking on the down arrow. You can
also begin typing the name of your
Inquirer Type in the field search bar to
find your Inquirer Type.
• For Inquiry Description, please provide
a comprehensive description,
including any applicable regulations.

Step 4: Submit the form.
• The Submit button will display when
all required fields are completed.
• When you click the Submit button, a
confirmation message with your Case
number will appear on the screen. You
will also receive an email confirmation
summarizing your request and
providing you with additional
guidance.
Public Health Emergency (PHE) Inquiry Form

Hover over any question mark icon to see more information about the field.

Select “I want to submit an inquiry request”.

Click on the down arrow to find your PHE selection or
begin typing the name of your PHE in the field search bar.

Retype your email address confirmation. Do not copy/paste.

Enter your phone number. (optional)
Click in the field and select from the list or begin typing the name
or abbreviation for your location in the field search bar.

Select the Organization Categories that best describe your
organization from any of the three tabs. At least one checkbox
is required, but you may select multiple checkboxes.

Click on the down arrow to find your Inquirer Type or
begin typing the name of your Inquirer Type in the
field search bar.

Please provide a comprehensive description including any applicable regulations.

*Note: The Submit button will display only after all
required fields are complete.
You will receive a system-generated email confirming that we have received your request. The
email will include the case number that has been assigned to your request, which you can
reference in any follow-up communications with CMS.

File and source

File: ppr-int-9792eef0836a46af-PHE-inquiry-PDF-fc071728d5.pdf
Size: 990,642 bytes
SHA-256: e367f6088d712b4d065b4c0ebee4e49830468d68c48441fddb68e756798f56e7
Our copy: ppr-int-9792eef0836a46af-PHE-inquiry-PDF-fc071728d5.pdf
Original: www.cms.gov