Keep Medicare appeals

When Medicare refuses to pay for nursing-home care, prescription drugs or other medical services, a beneficiary, physician or other health-care provider can appeal that decision, ultimately in a hearing before independent judges. Most times, the administrative law judges overturn the government's denial. So, Medicare beneficiaries have reason to be suspicious of a new federal policy that will limit starkly their chances of appealing to the judges in person.

The new policy, set to take effect by Oct. 1, eliminates the involvement of the Social Security Administration, which now allows in-person Medicare appeals at more than 140 offices throughout the country. Instead, under the U.S. Department of Health and Human Services, the judges would hold hearings, primarily by videoconference or telephone, at just four sites -- Miami; Arlington, Va.; Cleveland; and Irvine, Calif. To get a face-to-face hearing, a beneficiary must prove that "special or extraordinary circumstances exist."

The current way, the department says, is not feasible "economically or administratively." But there is no proof that videoconferencing would be especially efficient. Medicare's beneficiaries are 65 or older or disabled, and may be, as the Government Accountability Office found in a recent study, uncomfortable using the technology. There also are privacy issues, including those involving the use of fax machines to send private documents. Before dumping all 140 sites, the government should test -- and prove -- its "more cost-effective" way.