About OMHA

The Office of Medicare Hearings and Appeals (OMHA) is responsible for Level 3 of the Medicare claims appeal process; certain Medicare entitlement appeals; Part B and Part D premium appeals.

OMHA was created by the Medicare Modernization Act of 2003 to simplify the appeals process and make it more efficient. During an appeal, an OMHA Administrative Law Judge or attorney adjudicator conducts a new ("de novo") review of an appellant's case and issues a decision based on the facts and the law.

The Chief Administrative Law Judge leads the entire agency, which consists of ten field offices, one satellite office, and a headquarters office. Each field office is comprised of Administrative Law Judges, attorney adjudicators, and legal administrative staff who manage, process, and adjudicate dockets of appeals assigned by a Centralized Docketing Division. Field offices are overseen by an Associate Chief Administrative Law Judge and the satellite office is overseen by a Presiding Administrative Law Judge.