• Text Resize A A A
  • Print Print
  • Share Share on facebook Share on twitter Share

2017 OMHA Case Processing Manual (OCPM)

NOTE: OMHA is in the process of drafting new OCPM chapters and revising existing OCPM chapters to reflect changes to the manual’s format and organization. We are also making updates to address changes made by the Medicare appeals final rule that became effective March 20, 2017 (82 Fed. Reg. 4974 (Jan. 17, 2017)). The versions on this page were published before we began making these changes, and you should not rely upon specific instructions or time frames contained therein, as business processes may have changed.If an updated version has been published, there will be a link to it below. You can also view all new and updated versions of the chapters on the OMHA Case Processing Manual page. Please note that chapter numbering may have changed.

Division I. General Matters

Chapter 1. Manual Overview, Definition, Governance (See also: Chapter 1 of OCPM)

Chapter 2. Reserved

Chapter 3. Reserved

Chapter 4. Parties (See also: Chapter 4 of OCPM)

Chapter 5. Representatives (See also: Chapter 5 of OCPM)

Chapter 6. CMS and CMS Contractor Roles (See also: Chapter 6 of OCPM)

Chapter 7. Adjudication Time Frames (See also: Chapter 7 of OCPM)

Division II. Part A/B Claim Determinations

Chapter 1. Request and Correspondence Intake (See also: Chapter 9 of OCPM)

Chapter 2. Docketing and Assignment (See also: Chapter 9 of OCPM)

Chapter 3. Procedural Screening

Chapter 4. Administrative Record

Chapter 5. Reserved

Chapter 6. Pre-Hearing Case Development

Chapter 7. Scheduling and Notices of Hearing (See also: Chapter 14 of OCPM)

Chapter 8. Reserved

Chapter 9. Reserved

Chapter 10. Reserved

Chapter 11. Reserved

Chapter 12. Reserved

Chapter 13. Closing the Case (See also: Chapter 19 of OCPM)

Division III. Part C Organization Determinations

Chapter 1. Request and Correspondence Intake (See also: Chapter 9 of OCPM)

Chapter 2. Docketing and Assignment (See also: Chapter 9 of OCPM)

Chapter 3. Procedural Screening

Chapter 4. Administrative Record

Chapter 5. Reserved

Chapter 6. Reserved

Chapter 7. Scheduling and Notices of Hearing (See also: Chapter 14 of OCPM)

Chapter 8. Reserved

Chapter 9. Reserved

Chapter 10. Reserved

Chapter 11. Reserved

Chapter 12. Reserved

Chapter 13. Closing the Case (See also: Chapter 19 of OCPM)

Division IV. Part D Organization Determinations

Chapter 1. Request and Correspondence Intake (See also: Chapter 9 of OCPM)

Chapter 2. Docketing and Assignment (See also: Chapter 9 of OCPM)

Chapter 3. Procedural Screening

Chapter 4. Administrative Record

Chapter 5. Reserved

Chapter 6. Reserved

Chapter 7. Scheduling and Notices of Hearing (See also: Chapter 14 of OCPM)

Chapter 8. Reserved

Chapter 9. Reserved

Chapter 10. Reserved

Chapter 11. Reserved

Chapter 12. Reserved

Chapter 13. Closing the Case (See also: Chapter 19 of OCPM)

Division V. SSA Determinations

Chapter 1. Request and Correspondence Intake (See also: Chapter 9 of OCPM)

Chapter 2. Docketing and Assignment (See also: Chapter 9 of OCPM)

Chapter 3. Procedural Screening

Chapter 4. Administrative Record

Chapter 5. Reserved

Chapter 6. Reserved

Chapter 7. Scheduling and Notices of Hearing (See also: Chapter 14 of OCPM)

Chapter 8. Reserved

Chapter 9. Reserved

Chapter 10. Reserved

Chapter 11. Reserved

Chapter 12. Reserved

Chapter 13. Closing the Case (See also: Chapter 19 of OCPM)

Content created by Office of Medicare Hearings and Appeals (OMHA)
Content last reviewed on March 29, 2019