On September 1, 2022, CMS’ RDS Center announced an upcoming change to the Second Level Informal Hearing Appeals process.
In the coming months, CMS will introduce RDS Plan Sponsors to the new CMS Office of Hearings Case and Document Management System (OH CDMS). The OH CDMS is a web-based portal for RDS Plan Sponsors to submit and manage their Second Level Informal Hearing Appeals and to correspond with the CMS Hearing Officer. Access to specific cases is limited to the parties of the case, including party representatives. RDS support documentation and appropriate system email notifications will be modified accordingly.
RDS Programmatic requirements as defined in 42 C.F.R. 423.890(b) will not change with the implementation of the OH CDMS portal.
The RDS Secure Website (SWS) and the OH CDMS portal are separate web applications requiring separate and unique registrations and account management. Updated guidance will include information on how to register for the OH CDMS portal.
This change will only be relevant to Plan Sponsors who pursue an RDS Second Level Appeal. If a Plan Sponsor does not register on the OH CDMS portal, they cannot file an on-time Second Level Appeal.
RDS Plan Sponsors should register with the OH CDMS Portal if:
- The Plan Sponsor submitted a First Level Reconsideration for an RDS application, and
- The First Level Reconsideration was subsequently denied, and
- The Plan Sponsor now intends to request an Informal Hearing
RDS Plan Sponsors only need to register for the OH CDMS portal once. Registration is not required for each Second Level Appeal a Plan Sponsor wishes to pursue. Once a user is registered for the portal, that user will maintain a single active account for all RDS Second Level Appeals in the OH CDMS portal.
IMPORTANT: An Informal Hearing Request filed in the Second Level Appeal must be filed with the CMS Office of Hearings within 15 calendar days after receipt of the CMS Reconsideration Denial Decision in order to be considered. Therefore, to help ensure the Plan Sponsor meets the 15 day deadline, the CMS Office of Hearings requests that all Plan Sponsors and any outside representative organizations complete the one-time OH CDMS registration process as soon as Plan Sponsors receive the CMS Reconsideration Denial Decision, even if an organization is unsure whether it will appeal its CMS Reconsideration Denial. It is the Plan Sponsor’s responsibility to contact the OH CDMS Help Desk if they are experiencing any issues accessing or using the OH CDMS portal, especially during critical timeframes related to their Appeal(s). Plan Sponsors will continue to use the RDS Secure Website (SWS) to submit First Level Appeal Reconsiderations.
Please note that CMS’ RDS Center does not maintain the Office of Hearings Case and Document Management System. Because the OH CDMS portal falls entirely outside of the RDS Program’s purview, CMS’ RDS Center will not provide technical support for this web application. Please refer to CMS’ Electronic Filing page for support and contact information for the OH CDMS portal. User manuals are included on this page to assist with the registration process and the functionality of the Hearing Officer module.
This Second Level Appeal process change will not be relevant to First Level Reconsiderations or to Third Level Administrator Reviews. RDS Plan Sponsors will continue to use the RDS Secure Website to submit First Level Appeals and will continue to follow the existing process for Third Level Appeals, which is communicated to Plan Sponsors through email during the Appeals process. Please refer to Appeal an Initial Determination for additional information on RDS Appeals.
If you have questions or need additional information, please contact CMS' RDS Center.