OMHA administers the nationwide Administrative Law Judge (ALJ) hearing program for appeals arising from individual claims for Medicare coverage and payment for items and services furnished to beneficiaries (or enrollees) under Medicare Parts A, B, C and D. OMHA also hears appeals arising from claims for entitlement to Medicare benefits and disputes of Part B and Part D premium surcharges. OMHA generally conducts the third level of a five-level appeals process, and operates separately from the other agencies involved in the Medicare claims appeal process.
OMHA OPERATIONS DURING THE COVID-19 PANDEMIC
Although Office of Medicare Hearings and Appeals (OMHA) office space is closed to the general public, OMHA remains open for business with employees working under maximum telework flexibilities per U.S. Office of Personnel Management guidance. OMHA hearings and appeals processing measures are proceeding as scheduled. Unless an appellant is notified directly that a hearing has been postponed or canceled, appellants should continue to appear for hearings by telephone as scheduled. The Chief Administrative Law Judge supports the Administrative Law Judges exercising flexibility with regard to reasonable requests to reschedule hearings and reasonable requests for extension of time to file a request for hearing. OMHA staff are responding to phone calls to adjudication team phones and toll-free lines. In an effort to continue operations as seamlessly as possible, minimal staff will be on-site in OMHA offices to receive and send mail and faxes. Additional information and updates will be provided as the situation evolves.
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The Office of Medicare Hearings and Appeals (OMHA) has established a listserv to provide updates to our appellant community regarding the OMHA appeals process, special initiatives, pilot processes, OMHA website updates, etc. We encourage you to subscribe to our email list to stay informed!