![]() The Star Ratings system helps Medicare consumers compare the quality of Medicare health and drug plans being offered so they are empowered to make the best health care decisions for them. The Centers for Medicare & Medicaid Services (CMS) publishes the Medicare Advantage (Medicare Part C) and Medicare Part D Star Ratings each year to measure the quality of health and drug services received by consumers enrolled in Medicare Advantage (MA) and Prescription Drug Plans (PDPs or Part D plans). For details on the Medicare Advantage (MA) and Part D Star Ratings, please refer to the 2024 Part C & D Star Ratings Technical Notes available at. If you disagree with the OMHA's decision in level 3, you have 60 days after you get the decision to request a review by the Medicare Appeals Council (Appeals Council), which is level 4.Note: The information included in this Fact Sheet is based on the 2024 Star Ratings published on the Medicare Plan Finder on Octo. If OHMA doesn't issue a timely decision, you may ask OMHA to move your case to the next level of appeal. If OMHA decides in your favor, the plan has the right to appeal this decision by asking the Medicare Appeals Council (Appeals Council) for a review. If no hearing is held, either an ALJ or attorney adjudicator will review the information in your appeal record and issue a decision. If you have asked OMHA for a decision without a hearing, but the ALJ decides a hearing is necessary, the ALJ will let you know when the hearing will be. ![]() A written request stating that you don't wish to appear before an ALJ at a hearing (including a hearing held by phone or video-teleconference)Įven if you waive the ALJ hearing, a hearing may still be held by an ALJ if the other parties in your case who were sent a notice of hearing (for example, your provider) don’t also waive the ALJ hearing, or if the ALJ believes a hearing is necessary to decide your case.The "Waiver of Right to an Administrative Law Judge (ALJ) Hearing" form (Form OMHA-104).To request that OMHA make a decision without a hearing based only on the information that's in your appeal record, submit the information required for an ALJ hearing request and one of these: Can I request a review of my case without a hearing? You can find more information about the ALJ hearing process at the Office of Medicare Hearings and Appeals website, or call us at 1-800-MEDICARE (1-80). If you can't include this information with your request, include a statement explaining what you plan to submit and when you'll submit it. Any information that may help your case.An explanation of why you disagree with the IRE's reconsideration decision being appealed.The dates of service for the items or services you're appealing.The appeal number assigned by IRE, if any. ![]() If you've appointed a representative, include the name, address, and phone number of your representative. Your name, address, phone number, and Medicare number. ![]()
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