Medicare Appeals Council (Council)

The Medicare Appeals Council (Council) is an independent body within the U.S. Department of Health and Human Services responsible for reviewing appeals of Medicare coverage and payment decisions made by Administrative Law Judges (ALJs) and Qualified Independent Contractors (QICs). The Council serves as the highest level of administrative review within the Medicare appeals process, offering beneficiaries and providers an opportunity to challenge adverse decisions regarding coverage, payment, or eligibility. Through a thorough review of the appeal, the Council ensures that Medicare beneficiaries receive fair and impartial consideration of their claims, promoting transparency and accountability within the Medicare program.