January 4, 2012
Update to Federal District Court Amount in Controversy – Difference in CD-ROM Version of Jurisdiction C Supplier Manual
Update to Amount in Controversy
The Medicare Prescription Drug, Improvement, and Modernization Act requires an annual reevaluation of the dollar amount in controversy required for an Administrative Law Judge (ALJ) hearing or Federal District Court review. The amount in controversy increases by the percentage increase in the medical care component of the consumer price index for all urban consumers (U.S. city average) for July 2003 to the July preceding the year involved. Any amount that is not a multiple of $10 will be rounded to the nearest multiple of $10.
The amount that must remain in controversy for ALJ hearing requests filed on or before December 31, 2011, is $130. This amount will remain the same for calendar year 2012.
The amount that must remain in controversy for Federal District Court will increase to $1,350 for appeals to Federal District Court filed on or after January 1, 2012.
Web Version vs. CD-ROM Version of the Supplier Manual
The new Federal District Court amount in controversy information has been updated on our Appeals webpage and in the web version of the DME MAC Jurisdiction C Supplier Manual, Chapter 13, page 7; however, please note that the CD-ROM version of the Supplier Manual does not contain the updated amount in controversy information. If you use the CD-ROM version of the Supplier Manual, please be aware of this change and refer to the web version of Chapter 13 for the current monetary threshold amount. All other information in the web version and CD-ROM version of the Supplier Manual is identical.
