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CMS Raises Threshold Amounts for Medicare Appeals [Ober|Kaler]

CMS recently issued a notice that the amount in controversy necessary to pursue certain appeals will increase beginning January 1, 2013. The increase in the amount in controversy threshold relates to Administrative Law Judge (ALJ) hearings and subsequent judicial review for Medicare Part A and Part B appeals, Medicare Part C/Medicare Advantage appeals, and certain health maintenance organization and competitive health plan appeals. The thresholds are adjusted annually, as required by statute. The current threshold amount is $130 for an ALJ hearing and $1350 for judicial review. These amounts will be increased for appeal requests filed on or after January 1, 2013, to $140 for ALJ hearings and $1400 for judicial review.

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