Washington Note for Hearing (NTH) is a document issued by the U.S. Department of Health and Human Services (HHS) in order to inform patients of their right to request a hearing before an administrative law judge (ALJ) in response to certain decisions made by HHS. It is also intended to provide individuals with the information they need to participate in the hearing process. There are two types of NTH: the Notice of Final Adverse Action and the Notice of Opportunity for Hearing. The Notice of Final Adverse Action informs individuals of their right to request a hearing when a decision has been made that adversely affects their entitlement to Social Security benefits or another HHS-administered program, such as Medicaid. The Notice of Opportunity for Hearing informs individuals of their right to request a hearing before an ALJ when a decision has been made that adversely affects their eligibility for coverage under a medical assistance program. Both types of NTH provide individuals with instructions on how to request a hearing, the timeframe for submitting a request, and other relevant information.