CMS Pub. 100-04, ch. 29, § 345.1

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.