This is the final administrative appeal level — the next step would be federal district court

The amount in controversy must meet the threshold ($1,840 for 2024) for federal court review

Focus your brief on legal errors in the ALJ decision rather than re-arguing the facts

Medicarevery hard

Medicare Appeals Council Review Request

DAB-101 · HHS Departmental Appeals Board

Request for Medicare Appeals Council review. Fourth-level appeal after an Administrative Law Judge decision.

Form Details

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Where to Submit This Form

📬

Mail to the Medicare Appeals Council

Department of Health and Human Services Departmental Appeals Board, MS 6127 Medicare Appeals Council 330 Independence Avenue SW Washington, DC 20201

Filing Deadline

60 days from the date of the ALJ decision or dismissal.

Required Attachments

📎 Copy of the ALJ decision being appealed
📎 All prior appeal documentation and evidence
📎 Written brief or argument identifying errors in the ALJ decision
📎 Any new evidence with explanation of why it was not available at the ALJ hearing

Processing Time

90 days. The Medicare Appeals Council reviews on the record — no new hearing is held.

What Happens Next

The Medicare Appeals Council will review the ALJ decision for legal and factual errors. They can affirm, reverse, or remand the case. If unfavorable, the next step is federal district court.

Tips for This Form

✓ This is the final administrative appeal level — the next step would be federal district court
✓ The amount in controversy must meet the threshold ($1,840 for 2024) for federal court review
✓ Focus your brief on legal errors in the ALJ decision rather than re-arguing the facts
✓ An attorney experienced in Medicare appeals is strongly recommended at this level

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