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Decision Review

The Decision Review Process is only for providers that receive a Final Repayment Notice based on a HRSA finding of non-compliance or the results of an audit/assessment. Providers that would like to dispute HRSA’s request for repayment and/or the repayment amount can request a Decision Review. 

Providers that receive a Final Repayment Notice will be given information to access the Decision Review Portal to request a Decision Review. Only providers that have received an official Final Repayment Notice will be able to submit a Decision Review Request through the Portal. 

This process is not related to payment calculations and determinations. If you believe your payment was incorrectly calculated, please visit the Payment Reconsideration webpage.

How It Works

Providers will receive a Final Repayment Notice containing the repayment amount and the reason for owing funds. Providers who disagree with the repayment request have an opportunity to request a review of HRSA’s decision to seek recovery of PRF funds.

  1. Review the Final Repayment Notice sent by HRSA which contains important information needed for the Decision Review Process including:
    1. Reason for non-compliance
    2. Last three digits of Tax ID Number (TIN)
    3. Unique Repayment ID
    4. Repayment amount
    5. Web address for the Decision Review Portal
  2. Visit the Decision Review Portal and submit a Decision Review Request using the Unique Repayment ID within 60 days of the date of the Final Repayment Notice. Providers will receive a confirmation email once their request has been submitted.
  3. HRSA will notify providers once a decision is made or if additional information is required. All decisions are final. Results of a Decision Review that uphold the initial finding for repayment may be sent to the PSC for debt collection. For more details on the debt collection process, review the Repayment and Debt collection webpage. 

Unique Repayment IDs

Each repayment request corresponds to a single amount to be returned by a provider. Each repayment amount is eligible for a Decision Review and will have its own Unique Repayment ID.

  • The Decision Review Portal prompts providers to submit the Tax Identification Number, Unique Repayment ID and repayment amount for the repayment request to which they are requesting a Decision Review.  
  • Providers may have received more than one payment for which HRSA is seeking repayment. For example, providers may have failed to report on multiple payments received. Providers must complete a separate submission for each Unique Repayment ID that is identified in the Final Repayment Notice. Decision Review Requests cannot be combined. 
  • Providers are unable to submit duplicate submissions for a Unique Repayment ID. Once an ID has been used in a submitted Decision Review Request, that ID cannot be re-used. 

Documentation

Providers can submit documentation in the Decision Review Portal related to the (1) reason payments must be returned or (2) the amount HRSA has indicated must be repaid.

  • The Decision Review Portal only supports Microsoft Excel and Adobe PDF formats.  
  • There is a combined file limit of 25 MB per submission. The Portal does not accept submissions that exceed the file limit. 
  • Providers cannot upload additional documentation in the Portal after submitting a Decision Review Request, so providers are encouraged to carefully review all documentation before submitting their request.

Help With Decision Review

For additional information about requesting a decision review, or to verify a submission, contact the Decision Review Provider Support Line at the number located in the Final Repayment Notice. 

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