The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) provides for annual reevaluation of the dollar amount in controversy (AIC) required for an Administrative Law Judge (ALJ) hearing (third level review) and Federal District Court review (fifth level review).
For requests made on or after January 1, 2018:
• The amount that must remain in controversy for ALJ hearing requests will remain at $160.
• The amount that must remain in controversy for Federal District Court review is increased to $1,600.
I hope this article will help you with your appeals at the third and fifth levels. Thank you for being a Gold Member
All material posted on our website is the intellectual property of Gawenda Seminars & Consulting, Inc. and can’t be used, reproduced, or posted as your own material without the prior written approval of Gawenda Seminars & Consulting, Inc.
This article is not intended to and does not serve as legal advice or as consultative services, but is for general information purposes only.