Medicare Compliance & Reimbursement

Filing an administrative law judge (ALJ) request next year just got a little bit easier. You can expect the amount in controversy (AIC) to stay the same on Jan. 1.

Reminder: The Centers for Medicare & Medicaid Services (CMS) determines AIC thresholds for ALJ hearings, which are the third level of the Medicare appeals process. The AIC numbers are usually adjusted for inflation every year, but CMS has opted to carry over the 2021 threshold amounts for 2022, indicates an agency notice.

“The AIC threshold amount for ALJ hearings will remain at $180 and the AIC threshold amount for judicial review will remain at $1,760 for CY 2022,” the CMS notice says. “These amounts are based on the 76.149 percent increase in the medical care component of the CPI, which was at 297.600 in July 2003 and rose to 524.219 in July 2021.”

Read the Sept. 30 notice in the Federal Register at www.govinfo.gov/content/pkg/FR-2021-09-30/pdf/2021-21288.pdf.