Content created by Office of Medicare Hearings and Appeals (OMHA)
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 (See also: Chapter 11 of OCPM)
Chapter 4. Administrative Record (See also: Chapter 12 of OCPM)
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 (See also: Chapter 11 of OCPM)
Chapter 4. Administrative Record (See also: Chapter 12 of OCPM)
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 (See also: Chapter 11 of OCPM)
Chapter 4. Administrative Record (See also: Chapter 12 of OCPM)
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 (See also: Chapter 11 of OCPM)
Chapter 4. Administrative Record (See also: Chapter 12 of OCPM)
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)