PHOENIX--Two Medicare beneficiaries and a national organization seeking certification as a class action have filed a lawsuit against CMS challenging recent changes to the Medicare appeals process.
The complaint states that under Medicare's new appeals process--which transferred administrative law judges from the Social Security Administration to HHS in July--it is nearly impossible for a beneficiary to get an in-person hearing. The ALJ transfer was mandated by the MMA.
Eleanor Webber, Judith Schneider and The Gray Panthers Project Fund, a national organization of Medicare beneficiaries, filed the complaint last month in U.S. District Court for the District of Arizona, claiming that they were deprived of a fair and impartial hearing. Webber and Schneider received medical treatment that was determined to be not covered by Medicare, and their appeals are now at the ALJ stage, according to the complaint.
HHS currently has four hearing location sites, compared to 141 when appeals were handled by the SSA. While HHS claimed its use of video-teleconferencing in more than 1,000 cities would speed up the process, the lawsuit argues it denies beneficiaries a right to a fair hearing.
The complaint asks the court to issue a declaratory judgment that CMS' regulations violate the MMA by having only four sites and discouraging beneficiaries from seeking in-person hearings. It also asks, among other things, for a permanent injunction requiring CMS to give class action members an opportunity to receive in-person ALJ hearings.