Medicare Compliance & Reimbursement

Industry Notes:

AIC Changes for 2023 Are a Mixed Bag

If you’re filing an Administrative Law Judge (ALJ) request, expect one thing to remain status quo in 2023 — and another to increase.

Currently, the amount in controversy (AIC) threshold stands at $180 for ALJ hearings, and that number will stay the same for calendar year (CY) 2023, according to a Centers for Medicare & Medicaid Services (CMS) notice published in the Federal Register on Sept. 30. However, judicial review costs will rise from the 2022 amount of $1760 to $1850.

Why the change? The agency rounds the AIC threshold amounts to the nearest multiple of $10 after calculating figures from federally mandated percentage increases, CMS says. “These amounts are based on the 84.665 percent increase in the medical care component of the [consumer price index] CPI, which was at 297.600 in July 2003 and rose to 549.562 in July 2022.”

Review the notice at www.govinfo.gov/content/pkg/FR-2022-09-30/pdf/2022-21284.pdf.