Content created by Office of Medicare Hearings and Appeals (OMHA)
The Office of Medicare Hearings and Appeals (OMHA) is in charge of Level 3 of the Medicare appeals process. In order to appeal to OMHA, you must have passed through Level 1 and Level 2 of the appeals process. Click here for details on filing an appeal online through the OMHA e-Appeal Portal or by mail. Please note, the portal cannot accept appeal requests for Part A QIO (Quality Improvement Organization) appeals (such as Kepro or Livanta), Social Security Administration appeals, Medicare Secondary Payer appeals, Medicare Part C (Medicare Advantage) appeals, and Medicare Part D appeals at this time. Forms needed for your appeal are located here.
At Level 3 of the appeals process, your appeal will be reviewed by an OMHA adjudicator, and you may have a hearing before an Administrative Law Judge (ALJ). This gives you the opportunity to present your appeal to a new person who will independently review the facts of your appeal and make a new and impartial decision in accordance with the applicable law. If you have a hearing before an OMHA ALJ, the ALJ will also listen to your testimony before making a decision in accordance with the applicable law.
In some instances, an OMHA adjudicator may decide a case on the record if all parties who would be sent a notice of hearing waive their rights to an oral hearing or when the documentary evidence supports a finding fully favorable to the appellant, and no other party to the appeal is financially responsible for any of the claims at issue.
OMHA e-Appeal Portal Multi-Factor Authentication (MFA)
OMHA is continually assessing and enhancing the protection of personal information for millions of individuals accessing the OMHA e-Appeal Portal. We take this responsibility seriously and have implemented robust security measures to safeguard the personal information entrusted to us. Adding new, easy to use security measures is vital for keeping the public’s information safe and secure.
Beginning February 3, 2025, users will have the ability to sign in to the OMHA e-Appeal Portal using ID.me. This new method enhances security by requiring multi-factor authentication (MFA), which adds an extra layer of protection for personal information. MFA is a security process that requires you to provide two or more types of information to verify your identity before access is granted. For example, when signing into online banking with MFA, you may need a password and a code sent to your phone. This ensures that even if someone knows your password, they cannot access your account without additional verification.
To create an ID.me account, you will need to have a picture ID (such as a driver's license or passport) and an email address or phone number for verification. Setting up your ID.me account usually takes about 15-20 minutes. In some situations, a live video call may be required to verify your identity.
Effective March 3, 2025, the username and password method you currently use to access your OMHA e-Appeal Portal account will no longer be available, and you will need to utilize your ID.me account to access the OMHA e-Appeal Portal. This transition is part of our commitment to safeguarding user data and enhancing overall security measures. To ensure a smooth transition, we encourage you to familiarize yourself with the ID.me sign in process and take any necessary steps to set up your account before the official MFA implementation date of March 3, 2025. For assistance with ID.me, you can visit the ID.me Help Center.
OMHA is dedicated to providing convenient and secure online access to personal information, helping secure our users' present and future. While this update will require some time and extra steps, the added security MFA provides is essential to protect your data and the integrity of the appeals process. For assistance, you can find helpful resources at the following links:
These resources will guide you through the setup process and help you navigate any challenges you may encounter. If you have any questions or concerns, please contact a customer service representative at:
Beneficiaries: (844) 419-3358
All other appellants: (855) 556-8475
Medicare.Appeals@hhs.gov