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Your Administrative Law Judge (ALJ) Hearing

This section covers only OMHA’s role at Level 3 of the appeals process.  The appeals process begins at Level 1. In order to appeal to OMHA, you must have passed through Level 1 and Level 2 of the appeals process.  For more information, see "The Appeals Process."

What to Expect from the ALJ During the Hearing

  • The ALJ will explain the issues in your case and may question you and any witnesses you bring to the hearing.
  • The ALJ may ask other witness(es), such as a physician or other experts, to attend the hearing and provide testimony; you will have an opportunity to question any witness offering testimony at your hearing.
  • You and the witness(es) will answer questions under oath.
  • The ALJ makes an audio recording of the hearing.

Canceling an ALJ Hearing

Notify the Administrative Law Judge (ALJ) assigned to your appeal as soon as possible if you cannot attend a hearing.  In general, this notice must be given in writing. However, in emergency circumstances, oral requests will be accepted the day prior to or the day of the scheduled hearing.  The ALJ will reschedule the hearing if you have good cause for changing the time or place, and the time between the originally scheduled hearing date and the new date will not be counted toward the adjudication period.  If an ALJ changes the time or place of a hearing, an amended Notice of Hearing will be sent to all parties who were sent a copy of the Notice of Hearing and any CMS contractors that elected party or participant status. Your request for a hearing can be dismissed if you fail to appear at the hearing and the ALJ determines that you did not have good cause.
 

 

Content created by Office of Medicare Hearings and Appeals (OMHA)
Content last reviewed on September 11, 2016