Sunday, October 13, 2019

Updates to the OMHA Case Processing Manual

Lilly Hummel

The Office of Medicare Hearings and Appeals (OMHA) has published a  revised chapter of the OMHA Case Processing Manual (OCPM). Chapter 16 on Decisions has been revised effective October 9, 2019.

Effective July 8, 2019, OMHA also revised the following chapters:

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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