Bush Would Limit Medicare Appeals

[Guest guest]

http://consumeraffairs.com/news03/bush_appeals.html

Bush Would Limit Medicare Appeals

 

March 15, 2003

The Bush Administration is trying to make it harder for Medicare beneficiaries

to appeal the denial of such benefits as home health care and skilled nursing

home care. It's one of several Bush initiatives to limit citizens' right to

judicial review in matters involving health, personal injury and employment.

 

Tens of thousands of federal employees lost their right to appeal forced

transfers, firings and demotions under the Homeland Security Act and the

Administration is pushing hard to limit citizens' rights to punitive damage

awards in medical malpractice cases.

 

Now President Bush is proposing legislation that would severely limit the right

of federal judges to review cases involving the denial of Medicare services. He

wants to replace independent judges with mediators, hearing officers or others

appointed by the Department of Health and Human Services, the agency that runs

the Medicare program.

 

Secretary of Health and Human Services Tommy G. Thompson says the changes would

give his agency " flexibility to reform the appeals system, " allowing it to

operate in a more " efficient and effective manner. "

 

Currently, federal judges decide appeals under the Administrative Procedure Act,

a 1946 law that is intended to guarantee the fairness of government proceedings.

 

Individual beneficiaries have a big stake in the issue. When claims are denied,

the individual may be required to pay tens of thousands of dollars for services

already received.

 

In a typical case cited by The New York Times, an administrative law judge

ordered Medicare to pay for 230 home care visits to a 67-year-old woman with

breast cancer, heart disease and arthritis. Medicare officials had said the

woman should pay the cost. But the judge ordered Medicare to pay because the

woman was homebound and the services were " reasonable and necessary. "

 

Last year, Medicare beneficiaries and the providers who treated them won more

than half the cases -- 39,796 of the 77,388 Medicare cases decided by

administrative law judges, the Times reported.

 

Consumer organizations, judges and advocates for the aged were quick to attach

the Bush plan.

 

" We see President Bush's proposals as a serious assault ... on the rights of

citizens to fair, impartial hearings. These hearings guarantee due process of

law, as required by the Constitution, " said Ronald G. Bernoski, president of the

Association of Administrative Law Judges.

 

" The president's proposals would compromise the independence of administrative

law judges, who have protected beneficiaries in case after case, year after

year, " said Judith A. Stein, director of the Center for Medicare Advocacy in

Willimantic, Conn.

 

" This is a breath-taking assault on the most basic rights of American citizens

-- the right to seek justice before an impartial judge and jury, to be protected

from the power of government to seize one's life, liberty and property, " said

ConsumerAffairs.Com Founder & CEO James R. Hood.

 

" It is infuriating to hear Tommy Thompson talk about being 'efficient and

effective' in handling appeals from elderly individuals who, at the end of their

lives, are seeking such modest benefits as daily visits from a home health care

aide, " Hood said. " Government needs to be effective in delivering basic benefits

to its poor, elderly and dying -- not in finding new ways to deny those

benefits. "

 

 

 

 

 

 

 

 

 

 

 

 

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