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Healthcare Merchant Accreditation Appeals Policy

a) Notice of Appeal

  1. Provided Applicant/Accredited Entity is eligible for Appeal under Section 8 (Denial) of the Terms and Conditions, has ceased holding itself out as having Healthcare Merchant Accreditation, and all fees and expenses invoiced by NABP have been paid, Applicant/Accredited Entity may submit to NABP a written Notice of Appeal within 30 days of the date of the Denial Notice. To prevail, the Appellant must demonstrate that NABP (A) did not follow its established policies and/or procedures and/or made a substantive error of fact; and (B) that NABP’s failure to follow its established policies and/or procedures and/or NABP’s substantive error of fact resulted in the Denial.
  2. For appeal purposes, Applicant/Accredited Entity will be known as the “Appellant.”
  3. Appellant agrees to submit with its Notice of Appeal the $5,000 USD administrative fee for the appeal. The Notice and the fee must be sent to the following address:
    • National Association of Boards of Pharmacy
      Attn: Healthcare Merchant Accreditation
      1600 Feehanville Dr
      Mount Prospect, IL 60056
  4. If Appellant does not cease holding itself out as having Healthcare Merchant Accreditation or if a written Notice of Appeal and the required fee payment are not received by NABP within the designated time period, the Appeal Process ends, appeal of the Denial Notice is forfeited, the T&C terminate, and Appellant will have no further rights of internal appeal with NABP.
  5. In its Notice of Appeal, Appellant will include its position, explain why NABP’s decision was incorrect, and provide supporting information for its position.
  6. NABP may respond to Appellant’s Notice of Appeal, in which case it will respond no later than 30 days after receipt of Appellant’s Notice of Appeal, or such other time agreed to by the parties. If NABP elects to not respond to the Notice of Appeal, it will notify Appellant in writing.

b) Convening the Commission

  1. No more than 90 days from the Notice of Appeal, or such other time agreed to by the parties, the Commission will convene. The Commission consists of the NABP Executive Director and the NABP Policy and Communications Director.

c) Both parties to the appeal may be represented by counsel.

d) Any costs incurred by NABP over the initial administrative fee will be borne by the Appellant. Failure of Appellant to pay in full fees associated with the Appeal Process, including the Commission’s expenses, within 30 days of the date of the bill or invoice, will result in termination of the Appeal Process and the denial will be affirmed and the T&C will terminate.

e) In the event that a person designated as a member of the Commission shall be unable to serve for any reason at any time, an alternate member shall be selected by the Executive Director of NABP. The member’s service and affiliation with NABP, NABP’s Executive Committee, and the Commission shall not be grounds for disqualification based upon claims of conflict-of-interest, bias, or the like.

f) Articles for consideration.

  1. The Commission will only consider the Notice of Appeal, NABP’s response to Appellant’s Notice of Appeal, and the Healthcare Merchant Accreditation Terms and Conditions (T&C), including any documents incorporated or referenced within T&C (together, the ”Articles”).
  2. The only documents and information that may be included within the Notice of Appeal or NABP’s response to Appellant’s Notice of Appeal are:
    • Information provided by Appellant to NABP for the purpose of obtaining or maintaining Healthcare Merchant Accreditation;
    • Information NABP staff used to make its decision to deny Appellant Healthcare Merchant Accreditation; and
    • Any communications between Appellant and Healthcare Merchant Accreditation staff members.
  3. No new evidence, information, arguments, compliance plans, or witnesses can be presented to the Commission. Attempts to include new evidence, information, arguments, compliance plans, or witnesses will not be considered by the Commission and will be construed as violations of the T&C.
  4. No discovery is conducted. An in-person hearing is not conducted.
  5. NABP compiles the Articles for the Commission.
  6. NABP forwards copies of the Articles to the Commission at least one week prior to convening the Commission. A copy of the Articles is forwarded to the Appellant.

g) Commission powers and responsibilities.

  1. The two-member Commission reviews the Articles.
  2. Commission members may not consider a document or information that is not part of the Articles.
  3. The Commission members decide the appeal applying the standard of review set forth in the T&C.
  4. The Commission reserves the right to conduct a teleconference, at its sole discretion. Not more than two representatives of Appellant (e.g., Appellant’s attorney and an organizational representative) and two representatives from NABP’s Healthcare Merchant Accreditation program (e.g., attorney and a program representative) may participate in the teleconference. No new evidence, information, arguments, compliance plans, or witnesses can be presented to the Commission in the teleconference. Attempts to include new evidence, information, arguments, compliance plans, or witnesses will not be considered by the Commission and will be construed as violations of the T&C.

h) Decision and report.

  1. Unless another time period is agreed to by the parties, the Commission renders a decision not more than 120 days from the date of the Notice of Appeal.
  2. The Commission renders a decision applying the standard of review found in the T&C, and either:
    • Affirms the decision of NABP to issue the Denial Notice; or
    • Finds that NABP did not follow its established policies and/or procedures or made a substantive error of fact, and that these acts resulted in the issuance of a Denial Notice. The Commission will then reverse the decision of NABP and restore Appellant to its position prior to the initial notice within the Healthcare Merchant Accreditation Denial Process.
  3. The Commission conveys its decision to the Executive Director/Secretary of NABP, who will prepare a written report, on behalf of the Commission, setting forth the Commission’s decision. The Executive Director/Secretary will provide a copy of the report to the Appellant and its counsel as applicable, Commission members, and NABP counsel.

i) The decision of the Commission is final.

j) Appellant has no further rights to the Appeal Process, with NABP or the Commission, after the Commission has rendered a decision.

k) At any time, NABP, in its sole discretion, may amend the terms of this Healthcare Merchant Accreditation Appeals Policy. The applicable policy will be posted on the NABP website, or its successor website. The amended Healthcare Merchant Accreditation Appeals Policy will be effective for all appeals submitted after the date of publication of the amended policy.