Office of Medicare Hearings and Appeals (OMHA)

Level 5 Appeals

If you disagree with your Medicare Appeals Council (MAC) Level 4 decision and the amount in controversy is at least $1,180 (2008), you may file a civil action in your local Federal District Court. The notice of decision from the MAC will give you information about filing a civil action. This is the last level of appeals – Level 5.

Please note that your request must be filed with the Federal District Court within 60 days of receiving the Medicare Appeals Council decision.

You are reading about Level 5 of the Appeals Process.

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Please note that the Office of Medicare Hearings and Appeals is responsible only for the Level 3 claims appeals and certain Medicare entitlements and IRMAA appeals. OMHA is not responsible for levels 1, 2, 4, and 5 of the appeals process. OMHA provides additional information on other levels of appeals to help you understand the appeals process in a broad context.