Federal District Court Review

If the Medicare Appeals Council (Appeals Council) issues an adverse decision, or the Appeals Council denies the enrollee's request for review of an Administrative Law Judge's decision, the enrollee or enrollee's representative may request review by a Federal District Court.

For more information about appointing a representative, see section 60.1.1 in Chapter 13 of the Medicare Managed Care Manual.  You may view Chapter 13 by clicking on the link in the "Downloads" section below.

How to Request Review by a Federal District Court

To request review by a Federal District Court, the amount remaining in controversy (AIC) must meet a threshold requirement. This amount is recalculated each year and may change. For calendar year 2012, the AIC is $1,350.  For calendar year 2013, the AIC is $1,400.  To view the AIC Federal Register notices, click the links in the "Related Links" section below.

For more information about how the amount remaining in controversy is computed, see section 100.2 in Chapter 13 of the Medicare Managed Care Manual, in the "Downloads" section below.

The request for review must be filed with the proper Federal District Court within 60 calendar days of the date of the notice of the MAC's decision.

All requests must be made in writing.

For a description of the procedures an appellant must follow to request judicial review, go to sections 120 - 120.1 in Chapter 13 of the Medicare Managed Care Manual, click on the link in the "Downloads" section below.