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Office of Medicare Hearings and Appeals (OMHA)

Welcome to the Office of Medicare Hearings and Appeals

Welcome. This image shows a smiling young man with his arm around a smiling Medicare beneficiary.
The Office of Medicare Hearings and Appeals, under direct delegation from the Secretary of the Department of Health and Human Services, administers nationwide hearings for the Medicare program.  The Administrative Law Judges determine Level 3 appeals involving Parts A, B, C and D Medicare claims as well as other Medicare entitlement and premium issues, including income-related monthly adjustment amount (IRMAA) appeals.  OMHA consists of four field offices and a headquarters office.  OMHA is committed to resolving cases efficiently and fairly on a timely basis.

There are five levels in the Medicare claims appeal process. The Office of Medicare Hearings and Appeals holds hearings and issues decisions related to Medicare coverage determinations that reach Level 3 of the Medicare claims appeal process. This Web site was created to help you learn more about Level 3 appeals overseen by OMHA as well as the other Medicare entitlement and premium issues. You will find the following:

• Description of OMHA’s Level 3 appeals;
Forms needed for Level 3 appeals; and
• Description of what to expect.

Other information provided on this Web site:

OMHA’s Web site also contains information on the other levels of the appeals process.  While OMHA is not responsible for these other levels, some information is  provided to help you better understand the entire appeals process.