Fair Hearings: In-Person or Via Telephone?
Federal Medicaid regulations require that hearings be conducted “at a reasonable time, date, and place” (42 CFR 431.240(a)(1)). In the State Medicaid Manual, the Centers for Medicare and Medicaid Services, U.S. Department of Health and Human Services, provides guidance to states on fair hearings and says that state Medicaid agencies “may also conduct the hearing by telephone when the claimant is unable to attend in person (State Medicaid Manual, HCFA Pub 45-2, Section 2902.6 [August 1998]).”
In deciding whether to use a telephone hearing or an in-person hearing, consumer health assistance programs should carefully weigh the advantages of convenience against the advantages that an in-person appearance may afford consumers in making their case. One Administrative Law Judge advises that while some state agencies may steer people to telephone fair hearings to save money, they are not as advantageous to beneficiaries: "Papers are harder to exchange. People are harder to read. Questioning tends to be more perfunctory. The parties and the judge spend less time together. Those factors tend to affect the result. Superficiality favors the defense (in these cases, the Medicaid agency). Medicaid clients, who usually have the burden of proof, should almost always ask for face-to-face hearings." (Correspondence to the Health Assistance Partnership, September 2004)
Medicaid beneficiaries are entitled to request and to receive face-to-face hearings. Cases that support this include the following:
Armstrong v Magill (Tennessee Court of Appeals, 2004: 2004 WL 1462631): In this case regarding unemployment benefits, the Court of Appeals found that Armstrong’s due process rights were not violated because she was given an opportunity to choose between an in-person and telephonic hearing.
Whitesides v State of Alaska (Alaska Supreme Court, 2001: 20 P.3d 1130): In this case between a motorist and a state Department of Motor Vehicles, the Supreme Court of Alaska found that holding a hearing by telephone after the motorist had requested an in-person hearing violated the motorist’s due process rights.
Evans v State of New Mexico (New Mexico Court of Appeals, 1996: 122 N.M. 216, 922 P.2d 1212): This is another case between a motorist and a state Department of Motor Vehicles that discusses the Department’s responsibility to conduct in-person hearings. It holds that the state’s Implied Consent Act does not authorize telephone fair hearings and discusses the importance of in-person hearings when credibility determinations are made or when a decision-maker must observe and evaluate evidence or when the presence of a hearing officer “may be necessary for the participants to have a sense of fair play.”
Detroit Base Coalition v Department of Social Services (Michigan Supreme Court 1988: 431 Mich 172, 428 NW2d 335): A recipient of benefits of the Department of Social Services and an advocate organization brought action to prevent the Department from implementing a policy to mandate administrative hearings by telephone. The Court held that mandatory telephone hearings were inconsistent with existing rules and that instituting a telephone hearing policy violated rule-making provisions of the State's Administrative Procedure Act.
Note: The citation allows you to get the case quickly if you have access to a legal research tool like Westlaw or Lexus. If you do not have such access, Families USA can help you find these cases.
