Alternative Dispute Resolution Division
The Alternative Dispute Resolution Division provides alternative dispute resolution (“ADR”) services in appeals filed with the Board’s other three Divisions. ADR in Board cases typically involves either mediation or ombuds services.
The Appellate Division provides staff support for the Board Members, who are career civil servants appointed by the Secretary to provide an impartial, independent review of disputes arising in a wide range of HHS programs. The Board also provides appellate review of certain types of Administrative Law Judge decisions. In most cases, the Board decision is the final administrative decision of HHS.
Civil Remedies Division
The Civil Remedies Division (“CRD”) provides staff support for the Administrative Law Judges (“ALJs”) assigned to the DAB. The ALJs are qualified under the Federal Administrative Procedure Act to conduct hearings on the record. Generally, the ALJ decision is an initial decision that may be appealed to the Board. If the ALJ decision is not appealed, it represents the final administrative decision.
Medicare Operations Division
The Medicare Operations Division provides staff support to the Administrative Appeals Judges and Appeals Officers on the Medicare Appeals Council. The Council provides the final administrative review of claims for entitlement to Medicare and individual claims for Medicare coverage and payment filed by beneficiaries or health care providers/suppliers.