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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 $1,350 (2012), 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.
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Level 1 AppealsLevel 2 AppealsLevel 3 appealsLevel 4 AppealsLevel 5 AppealsYou are reading about Level 5 of the Appeals Process.
 Select any level for more information.

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.