CMA files class action challenging new Medicare regs

On May 24, 2005, attorneys from the Center for Medicare Advocacy filed a
lawsuit in federal court in Hartford challenging the Medicare=s refusal
to send a copy of Initial Determination notices to the representative of
the beneficiary.  The suit was filed on behalf of a nationwide class of
Medicare beneficiaries.

The case, Lirot v. Leavitt, was brought because, without receiving a
copy of the notice, representatives frequently do not know that an
initial determination has been issued and that the time to seek review
is running.  They are dependent on the beneficiary to decipher the
Medicare Summary Notice (MSN), which the Secretary deems an initial
determination, and to grasp that the representative needs to be informed
of its content.  The failure to seek redetermination of the initial
determination cuts off the beneficiary from any possibility of
administrative or judicial review, unless the intermediary can be
convinced that there was good cause for the failure.