[Federal Register Volume 85, Number 127 (Wednesday, July 1, 2020)]
[Notices]
[Pages 39571-39573]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2020-14203]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

[OMHA-1903-N]


Medicare Program; Administrative Law Judge Hearing Program for 
Medicare Claim and Entitlement Appeals; Quarterly Listing of Program 
Issuances--October 2019 Through March 2020

AGENCY: Office of Medicare Hearings and Appeals (OMHA), Health and 
Human Services (HHS).

ACTION: Notice.

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SUMMARY: This notice lists the OMHA Case Processing Manual (OCPM) 
instructions that were published from October 2019 through March 2020. 
This

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manual standardizes the day-to-day procedures for carrying out 
adjudicative functions, in accordance with applicable statutes, 
regulations, and OMHA directives, and gives OMHA staff direction for 
processing appeals at the OMHA level of adjudication.

FOR FURTHER INFORMATION CONTACT: Jon Dorman, by telephone at (571) 457-
7220, or by email at [email protected].

SUPPLEMENTARY INFORMATION:

I. Background

    The Office of Medicare Hearings and Appeals (OMHA), a staff 
division within the Office of the Secretary within the U.S. Department 
of Health and Human Services (HHS), administers the nationwide 
Administrative Law Judge hearing program for Medicare claim; 
organization, coverage, and at-risk determination; and entitlement 
appeals under sections 1869, 1155, 1876(c)(5)(B), 1852(g)(5), and 
1860D-4(h) of the Social Security Act (the Act). OMHA ensures that 
Medicare beneficiaries and the providers and suppliers that furnish 
items or services to Medicare beneficiaries, as well as Medicare 
Advantage organizations (MAOs), Medicaid State agencies, and applicable 
plans, have a fair and impartial forum to address disagreements with 
Medicare coverage and payment determinations made by Medicare 
contractors, MAOs, or Part D plan sponsors (PDPSs), and determinations 
related to Medicare eligibility and entitlement, Part B late enrollment 
penalty, and income-related monthly adjustment amounts (IRMAA) made by 
the Social Security Administration (SSA).
    The Medicare claim, organization determination, coverage 
determination, and at-risk determination appeals processes consist of 
four levels of administrative review, and a fifth level of review with 
the Federal district courts after administrative remedies under HHS 
regulations have been exhausted. The first two levels of review are 
administered by the Centers for Medicare & Medicaid Services (CMS) and 
conducted by Medicare contractors for claim appeals, by MAOs and an 
Independent Review Entity (IRE) for Part C organization determination 
appeals, or by PDPSs and an IRE for Part D coverage determination and 
at-risk determination appeals. The third level of review is 
administered by OMHA and conducted by Administrative Law Judges and 
attorney adjudicators. The fourth level of review is administered by 
the HHS Departmental Appeals Board (DAB) and conducted by the Medicare 
Appeals Council (Council). In addition, OMHA and the DAB administer the 
second and third levels of appeal, respectively, for Medicare 
eligibility, entitlement, Part B late enrollment penalty, and IRMAA 
reconsiderations made by SSA; a fourth level of review with the Federal 
district courts is available after administrative remedies within SSA 
and HHS have been exhausted.
    Sections 1869, 1155, 1876(c)(5)(B), 1852(g)(5), and 1860D-4(h) of 
the Act are implemented through the regulations at 42 CFR part 405, 
subparts I and J; part 417, subpart Q; part 422, subpart M; part 423, 
subparts M and U; and part 478, subpart B. As noted above, OMHA 
administers the nationwide Administrative Law Judge hearing program in 
accordance with these statutes and applicable regulations. To help 
ensure nationwide consistency in that effort, OMHA established a 
manual, the OCPM. Through the OCPM, the OMHA Chief Administrative Law 
Judge establishes the day-to-day procedures for carrying out 
adjudicative functions, in accordance with applicable statutes, 
regulations, and OMHA directives. The OCPM provides direction for 
processing appeals at the OMHA level of adjudication for Medicare Part 
A and B claims; Part C organization determinations; Part D coverage 
determinations and at-risk determinations; and SSA eligibility and 
entitlement, Part B late enrollment penalty, and IRMAA determinations.
    Section 1871(c) of the Act requires that the Secretary publish a 
list of all Medicare manual instructions, interpretive rules, 
statements of policy, and guidelines of general applicability not 
issued as regulations at least every three months in the Federal 
Register.

II. Format for the Quarterly Issuance Notices

    This notice provides the specific updates to the OCPM that have 
occurred in the period of October 2019 through March 2020. A hyperlink 
to the available chapters on the OMHA website is provided below. The 
OMHA website contains the most current, up-to-date chapters and 
revisions to chapters, and will be available earlier than we publish 
our quarterly notice. We believe the OMHA website provides more timely 
access to the current OCPM chapters for those involved in the Medicare 
claim; organization, coverage, and at-risk determination; and 
entitlement appeals processes. We also believe the website offers the 
public a more convenient tool for real time access to current OCPM 
provisions. In addition, OMHA has a listserv to which the public can 
subscribe to receive notification of certain updates to the OMHA 
website, including when new or revised OCPM chapters are posted. If 
accessing the OMHA website proves to be difficult, the contact person 
listed above can provide the information.

III. How to Use the Notice

    This notice lists the OCPM chapters and subjects published during 
the period covered by the notice so the reader may determine whether 
any are of particular interest. The OCPM can be accessed at https://www.hhs.gov/about/agencies/omha/the-appeals-process/case-processing-manual/index.html.

IV. OCPM Releases for October 2019 Through March 2020

    The OCPM is used by OMHA adjudicators and staff to administer the 
OMHA program. It offers day-to-day operating instructions, policies, 
and procedures based on statutes and regulations, and OMHA directives.
    The following is a list and description of OCPM provisions that 
were issued or revised in the period of October 2019 through March 
2020. This information is available on our website at https://www.hhs.gov/about/agencies/omha/the-appeals-process/case-processing-manual/index.html.

OCPM Chapter 16: Decisions

    On October 9, 2019, OMHA issued OCPM Chapter 16, which describes 
the structure and content of the decisions issued by OMHA adjudicators. 
The chapter details when an adjudicator classifies a decision as 
favorable or fully favorable, unfavorable, or partially favorable, and 
the effect the financial responsibility determination has on the 
characterization of the decision. Additionally, the chapter provides 
general writing guidelines and the protocols for protecting personally 
identifiable and protected health information in a decision. The 
chapter also describes the format for a decision affirming the 
dismissal of a request for reconsideration, a decision addressing 
multiple consolidated appeals, and a stipulated decision. An OMHA-
approved notice of decision template must accompany every decision and 
describes the parties' appeals rights. OMHA also issued a Citation 
Policy as chapter support material to Chapter 16.

OCPM Chapter 15: Conducting Conferences and Hearings: Posthearing 
Development

    On November 21, 2019, OMHA issued OCPM Chapter 15, which describes 
the process used by OMHA adjudicators when conducting prehearing/

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posthearing conferences and hearings. The chapter details regulatory 
requirements, OMHA administrative requirements, and suggested best 
practices when conducting a conference or hearing. The chapter also 
explains when and how to hold a consolidated, supplemental, or 
continued hearing; the procedures for responding to a request for a 
copy of the administrative record; and available actions that can be 
taken to develop the administrative record after an initial hearing has 
been conducted.

OCPM Chapter 10: Party and Non-Party Participant Requests and 
Submissions

    On February 19, 2020, OMHA issued OCPM Chapter 10, which explains 
how to route, document and address contacts from parties and non-party 
participants involving both general and case-specific matters. The 
chapter describes how to provide language or communication assistance 
services to individuals with limited English proficiency or a 
disability, and summarizes the services OMHA offers in response to such 
requests. The chapter also explains how to process requests for a stay 
of proceedings, discovery, or subpoena; and review submissions of 
evidence and other case-related materials. Many types of requests and 
submissions that generally occur at a specific stage in the 
adjudication process are covered in detail in other OCPM chapters. To 
facilitate locating this information, Chapter 10 contains a list of 
these requests and submissions, along with cross-references to the 
specific OCPM provisions where they are discussed.

    Dated: June 26, 2020.
Karen W. Ames,
Executive Director, Office of Medicare Hearings and Appeals.
[FR Doc. 2020-14203 Filed 6-30-20; 8:45 am]
BILLING CODE 4150-46-P