tci Part B Insider - 2009 Issue 5

PART B APPEALS: CMS Changes Dollar Amount Threshold for U.S. Court Appeals

$1,220 must be in dispute to qualify for district court hearing. Forty dollars may not sound like a lot of money, but it could be enough to shoot down your hopes of getting your appeal heard in court. Practices that use U.S. District Court appeal hearings as their last resort for getting unclaimed reimbursement may be disappointed to learn that CMS has raised the threshold amount required for a these hearings from $1,180 to $1,220. What does this mean? The amount of reimbursement in controversy has to be $1,120 or more to qualify for...

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