CMS Small Business Administration Ombudsman

CMS Liaison to the Small Business Administration (SBA), Office of the National Ombudsman (ONO)

This web page is a guide to assist small businesses and other small entities experiencing difficulties doing business with CMS, application of CMS regulations, or seeking grant or contract assistance from CMS. The Office of Strategic Operations and Regulatory Affairs (OSORA) serves as the CMS liaison to the SBA ONO, managing policy oversight and the review and resolution of comments shared by small businesses. 

CMS encourages small businesses and other small entities to request assistance directly from CMS, or through the Office of the National Ombudsman (ONO) at the Small Business Administration (SBA), on any concern about treatment by CMS officials or contractors. CMS is committed to maintaining an environment where small entities are free, and encouraged, to raise complaints, questions, or concerns about any CMS policies, regulations, actions, or practices. No CMS employee is allowed to take any type of retaliatory action against any entity raising a complaint, question, or concern. Any allegations of retaliation will be investigated and appropriate action taken to correct the situation. In addition, small entities may comment to the SBA ONO if there are any concerns about CMS responsiveness or adherence to this policy. The SBA ONO can be reached by telephone at (202) 205-2417, facsimile at (202) 481-5719, email at ombudsman@sba.gov, or through its web site via the link under "Related Links" at the bottom of this page. 

Regulatory Flexibility Act

All CMS regulations are subject to the Regulatory Flexibility Act (RFA). The RFA requires agencies to minimize regulatory burden on small businesses and other small entities. Every proposed rule must contain either a certification that it does not impose a significant impact on a substantial number of small entities, or an Initial Regulatory Flexibility Analysis. Resulting final rules must contain a certification or a Final Regulatory Flexibility Analysis. Proposed rules must, by law, allow comments from any interested party or affected entity, and CMS must respond to those comments in final rules. Any small business or other small entity is strongly encouraged to use this comment process to advise CMS on how to reduce or eliminate burdens. Each regulatory proposal contains contact information to facilitate participation by the public. Any complaints or concerns about CMS regulations can also be reported to the ONO or to the Office of Advocacy at SBA (web accessible via the link under "Related Links" at the bottom of this page).

CMS Small Entity Compliance Guides

The Small Business Regulatory Enforcement Fairness Act of 1996 (SBREFA, Pub. L. 104-121, as amended by Pub. L. 110-28, May 25, 2007 and Pub. L. 117-188, Oct 22, 2022), contains specific requirements federal agencies must comply with. When a regulation creates new compliance requirements with a significant economic impact, CMS provides a small entity compliance guide for each regulation that explains what actions affected entities must take to comply with agency rules. Access the CMS Small Entity Compliance Guides web page under “Related Links” at the bottom of this page for a full listing of these guides. 

Open Door Forums

CMS regularly conducts “Open Door Forums” on topics of interest to our providers, beneficiaries, and other stakeholders, including small businesses and other small entities. These forums provide an opportunity to obtain information, ask questions, and express your views to senior CMS officials. We are particularly interested in ideas to reduce unnecessary burden or costs. You can attend virtually from anywhere in the United States. These forums often result in improvements in CMS policies, regulations, and practices that benefit all our stakeholders. To obtain information on these forums or to sign up for notification of future forums, access the Open Door Forum web page under "Related Links" at the bottom of this page.

Contract Opportunities

CMS has a dedicated Small Business Specialist from the HHS Office of Small and Disadvantaged Business Utilization (OSDBU). OSDBU works to ensure that small businesses, small disadvantaged businesses, 8(a) business development program, women-owned, service-disabled veteran-owned, and HUBZone businesses have access to contract opportunities. To learn more, access the HHS Office of Small and Disadvantaged Business Utilization web page under “Related Links” at the bottom of this page.

Grant Opportunities

While CMS's Program Offices are concerned with the scientific, technical, and programmatic topics, the Office of Acquisition and Grants Management (OAGM), Grants Management Group is primarily charged with the business management and policy aspects of CMS's discretionary grant and cooperative agreement activities. To learn more, access the Grants and Cooperative Agreements web page under “Related Links” at the bottom of this page.