New OMHA Appeals Case Processing Manual Chapters

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New OMHA Appeals Case Processing Manual Chapters

Lilly Hummel


The Office of Medicare Hearings and Appeals (OMHA) has published six new or revised chapters of the OMHA Case Processing Manual (OCPM). This manual standardizes the day-to-day procedures for carrying out adjudicative functions. OMHA is still in the process of drafting additional new OCPM chapters and revising existing chapters under a new format. The following new or revised chapters have been issued since May 10, 2018:
  • Chapter 1, Manual Overview, Definition, Governance [New, effective 5-25-18]
  • Chapter 5, Representatives [Revised, effective 7-27-18]
  • Chapter 6, CMS, CMS Contractor, and Plan Roles [Revised, effective 7-27-18]
  •  Chapter 7, Adjudication Time Frames, Case Prioritization, and Escalations [Revised, effective 7-27-18]
  • Chapter 19, Closing the Case [Revised, effective 5-25-18]
  • Chapter 20, Post-Adjudication Actions [New, effective 5-25-18]



These new and revised OCPM chapters can be accessed here. Chapters that were published before May 10, 2018, can be accessed here


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