Wednesday, July 17, 2019

Updates to the OMHA Case Processing Manual

The Office of Medicare Hearings and Appeals (OMHA) has published ten revised chapters of the OMHA Case Processing Manual (OCPM). The revised chapters, which were effective July 8, 2019, are:
  • Chapter 4; Parties 
  • Chapter 5; Representatives 
  • Chapter 6; CMS, CMS Contractor, and Plan Roles 
  • Chapter 7; Adjudication Time Frames, Case Prioritization, and Escalations 
  • Chapter 9; Request and Correspondence Intake, Docketing, and Assignment 
  • Chapter 11; Procedural Review and Determinations 
  • Chapter 14; Scheduling and Noticing for Prehearing Conferences and Hearings 
  • Chapter 17; Dismissals 
  • Chapter 18; Requests for Information and Remands
  • Chapter 20; Post-Adjudication Actions
This manual standardizes the day-to-day procedures for carrying out adjudicative functions, in accordance with applicable statutes, regulations, and OMHA directives, and gives OMHA staff direction for processing appeals at the OMHA level of adjudication. As part of an ongoing effort to make the manual more user friendly and reflect recent regulatory changes, OMHA is in the process of drafting new OCPM chapters and revising existing chapters under a new format.

New and revised OCPM chapters can be accessed at https://www.hhs.gov/about/agencies/omha/the-appeals-process/case-processing-manual/index.html.

Chapters that were published before May 10, 2018, can be accessed at:
https://www.hhs.gov/about/agencies/omha/the-appeals-process/case-processing-manual/2017/index.html.

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