Abbey v. Sullivan

McLAUGHLIN, Circuit Judge:

Plaintiffs are participants in the Medicare Part B program, 42 U.S.C. §§ 1395j-1395w-4. They presented claims for medical benefits to Empire Blue Cross and Blue Shield (“Empire”) and Blue Shield of Western New York (“BSWNY”); these are private insurance carriers with whom the government has contracted to administer the Part B claims process. Each plaintiff requested a “fair hearing” to review the award of benefits, and Hearing Officers (“HOs”) were assigned to conduct the hearings. Although such “hearings” are generally conducted solely on documentary evidence…