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Coming Soon – Changes to Second Level Informal Hearing Appeals Process

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The Centers for Medicare and Medicaid Services (CMS) will soon implement changes to the Retiree Drug Subsidy (RDS) 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 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.

This change will only be relevant to Plan Sponsors who pursue an RDS Second Level Appeal. Only Plan Sponsors who have submitted a First Level Reconsideration that was subsequently denied, and who wish to request an Informal Hearing, are affected by this process change.

This change will not be relevant to First Level Reconsiderations or to Third Level Administrator Reviews. RDS Plan Sponsors will continue to follow the existing process for those Appeals. Please refer to Appeal an Initial Determination for guidance on RDS Appeals. 

Please note that CMS’ RDS Center will 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. Contact information for OH CDMS support will be provided in future communications.

Additional information will be provided to the RDS Plan Sponsor community as details are made available, including contact information for OH CDMS support. If you have questions or need additional information, please contact CMS' RDS Center.

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