Requests for U.S. District Court Review by a Party

345.1 - Requests for U.S. District Court Review by a Party (Rev. 4278, Issued: 04-12-19, Effective: 06-13-19, Implementation: 06-13-19) Following issuance of a decision by the Appeals Council, a party may request judicial review of the Appeals Council’s decision. A MAC cannot accept requests for judicial review. The appellant must file the complaint with the U.S. District Court. See 42 CFR 405.1136. If a party files a request for judicial review with a MAC, the MAC must immediately notify the appellant that the complaint must be filed with the appropriate U.S. District Court (i.e., the district court for the judicial district in which the party resides or where such individual, institution, or agency has its principal place of business). However, the appellant is responsible for determining where the complaint must be filed. MACs shall not forward the complaint to a district court as a courtesy to the appellant. The amount remaining in controversy must meet the required threshold. Current amount in controversy threshold figure available on the CMS website at: http://www.cms.gov/Medicare/Appeals-and-Grievances/OrgMedFFSAppeals/Review-Federal- District-Court.html. See §250. If a MAC receives a copy of a summons or complaint for judicial review in federal district court, and it does not appear that a copy was sent to the following address, the MAC shall send the original to: Department of Health and Human Services General Counsel 200 Independence Avenue, S.W. Washington, D.C. 20201 The MAC retains a copy and notifies its Contracting Officer’s Representative (COR) immediately. The CMS COR should alert the CMS Central Office Counsel that a complaint has been forwarded by the MAC to the HHS General Counsel’s office.