S. 1335

Justice for Medicare Beneficiaries Act of 2005

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II

109th CONGRESS

1st Session

S. 1335

IN THE SENATE OF THE UNITED STATES

June 29, 2005

Mr. Dodd (for himself, Mr. Kennedy, Mr. Kerry, and Mr. Bingaman) introduced the following bill; which was read twice and referred to the Committee on Finance

A BILL

To amend title XVIII of the Social Security Act to preserve access to appeals before administrative law judges under the medicare program.

1.

Short title

This Act may be cited as the Justice for Medicare Beneficiaries Act of 2005.

2.

Preserving access to administrative law judges under the medicare program

(a)

Requirements for the implementation of the transfer of adjudication authority

Section 931(b) of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Public Law 108–173; 117 Stat. 2398) is amended—

(1)

in paragraph (2), by adding at the end the following new sentence: Such judges shall be bound only by applicable statutes, regulations, and rulings issued in accordance with subchapter II of chapter 5, and chapter 7, of title 5, United States Code (commonly known as the Administrative Procedures Act) and shall not be required to give substantial deference to local coverage determinations, local medical review policies, or Centers for Medicare & Medicaid Services program guidance.;

(2)

in paragraph (3), by adding at the end the following new sentence:

In providing for the distribution of administrative law judges under the preceding sentence, the Secretary shall ensure that—

(A)

there is at least 1 site in each State, the District of Columbia, and each territory for in-person hearings before an administrative law judge; and

(B)

there are at least 2 such sites in the 5 States with the largest populations, such sites being geographically distributed within the State.

; and

(3)

by adding at the end the following new paragraph:

(7)

Hearings before administrative law judges for medicare beneficiaries

The Secretary shall ensure that if an individual entitled to benefits under part A of title XVIII of the Social Security Act or enrolled under part B of such title requests a hearing before an administrative law judge, such hearing shall be in-person unless such individual requests that the hearing be conducted using tele- or video conference technologies. The Secretary shall also ensure that the time frame for an administrative law judge to decide an appeal is not different for hearings conducted in-person and hearings using tele- or video conference technologies.

.

(b)

Delay in the transfer of adjudication authority in order to comply with amendments

Section 931(b)(1) of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Public Law 108–173; 117 Stat. 2398) is amended by striking October 1, 2005 and inserting October 1, 2006.

(c)

Effective Date

The amendments made by this section shall take effect as if included in the enactment of section 931(b) of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Public Law 108–173; 117 Stat. 2398).