CMS - Changes to Amount in Controversy Threshold effective Jan 1, 2024

Did you know that the amount in controversy to obtain an administrative law judge (ALJ) hearing and/or a judicial review in federal district court is changing effective January 1, 2024?

Beginning January 1, 2024, the thresholds will be:

  • ALJ hearing - $180
  • Federal district court - $1,840

Here is how to calculate the amount in controversy -

  • The amount charged minus Medicare payments already made or awarded = subtotal balance
  • Subtotal balance minus any applicable deductible/coinsurance = AIC (Amount in Controversy)

Source

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