November 10, 2017
Updated 2018 Amount in Controversy (AIC) for Administrative Law Judge Hearings or Federal District Court Appeals
The Centers for Medicare & Medicaid Services (CMS) has notified Medicare contractors of the update to the Amount in Controversy (AIC) required to sustain Administrative Law Judge (ALJ) or Federal District Court appeal rights beginning January 1, 2018.
- The amount remaining in controversy requirement for ALJ hearing requests made on or before December 31, 2017, is $160. This amount will remain at $160 for ALJ hearing requests filed on or after January 1, 2018.
- The amount that must remain in controversy for reviews in Federal District Court requested on or before December 31, 2017 is $1,560. This amount will increase to $1,600 for appeals to Federal District Court filed on or after January 1, 2018.
Please share this with your appropriate staff.
For additional information about appeals, refer to the Medicare Appeals Process factsheet, which provides an overview of the Medicare Part A and Part B administrative appeals process available to providers, physicians and other suppliers who provide services and supplies to Medicare beneficiaries, as well as details on where to obtain more information about this appeals process. The factsheet is available on the CMS Web site