A new federal policy will make it significantly more difficult for Medicare beneficiaries to obtain hearings in person before a judge when the government denies their claims for home care, nursing home services, prescription drugs and other treatments.
Senator Charles E. Grassley, the Iowa Republican who is chairman of the Finance Committee, and Senator Max Baucus of Montana, the senior Democrat on the panel, said four hearing offices were not enough.Mr. Grassley and Mr. Baucus were among the principal authors of the 2003 Medicare law. The law, they noted, says Medicare judges are to be distributed "throughout the United States."
Under the new arrangement, hearings for Medicare beneficiaries in New York, New Jersey and all of New England will normally be held by judges in Cleveland. Hearings for people in Iowa, Kansas, Missouri and Nebraska will be held by judges in Southern California.
Judith A. Stein, director of the Center for Medicare Advocacy, which has represented thousands of people in hearings since 1986, said: "The videoconferences are one of many changes that will reduce the beneficiaries' ability to get fair, favorable decisions. Sick, old and disabled people can be much more effective in person because the judge can see their illnesses and infirmities - how they walk, how they get up from a chair, how their hands shake with tremors."
The government is still working out details and lining up sites with the necessary videoconference links. Nancy A. Thompson, director of the transition team at the department, refused to answer questions about the new hearing and appeal procedures or the logistical arrangements.
Ronald T. Osborn of Charlotte, N.C., who has been an administrative law judge since 1974 and has specialized in Medicare cases since 1996, said he had no interest in moving to the Department of Health and Human Services.
"Under the department's procedural rules," Mr. Osborn said, "judges will have less freedom to handle individual cases as they see fit."
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