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21-003652 Robert C. Cava, M.D. On Behalf Of Gary Kramer vs. Department Of Management Services, Division Of State Group Insurance
 Status: Closed
Recommended Order on Wednesday, June 1, 2022.

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Summary: DSGI proved that the use of Xeljanz by Petitioner for his medical condition was not covered by the State PPO Plan, since it was excluded from coverage as not medically necessary, or experimental or investigational, as those terms were defined by the Plan.
  • Document: Recommended Order
  • Issued: 06/01/2022
  • Summary: DSGI proved that the use of Xeljanz by Petitioner for his medical condition was not covered by the State PPO Plan, since it was excluded from coverage as not medically necessary, or experimental or investigational, as those terms were defined by the Plan.
Dockets
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Date
Proceedings
PDF:
Date: 06/16/2022
Proceedings: Cover Letter Re Petitioners Exceptions to Recommended Order filed.
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Date: 06/16/2022
Proceedings: Motion for Confidential Court Filing of Petitioner's Exceptions to Recommended Order filed.
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Date: 06/01/2022
Proceedings: Recommended Order
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Date: 06/01/2022
Proceedings: Recommended Order (hearing held March 17, 2022). CASE CLOSED.
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Date: 06/01/2022
Proceedings: Recommended Order cover letter identifying the hearing record referred to the Agency.
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Date: 05/02/2022
Proceedings: Joint Motion for Confidential Court Filing of Proposed Recommended Orders filed.
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Date: 04/12/2022
Proceedings: Order Granting Extension of Time.
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Date: 04/12/2022
Proceedings: Unopposed Motion for Extension of Time to File Proposed Order filed.
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Date: 04/12/2022
Proceedings: Notice of Unavailability filed.
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Date: 04/11/2022
Proceedings: Notice of Final Hearing Transcript.
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Date: 04/11/2022
Proceedings: Transcript of Proceedings filed.
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Date: 04/06/2022
Proceedings: Notice of Filing CV of Antonella Tosti, M.D. filed.
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Date: 03/11/2022
Proceedings: Order Granting Motion to Determine Confidentiality of Documents.
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Date: 03/11/2022
Proceedings: Order Granting Extension of Time.
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Date: 03/11/2022
Proceedings: Motion for Confidentiality of Petitioner's Exhibits and Witness List filed.
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Date: 03/11/2022
Proceedings: Petitioner's Motion for Extension of Time to Mail Documents for Hearing 03.17.22 filed.
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Date: 03/10/2022
Proceedings: Motion to Determine Confidentiality of Document filed.
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Date: 03/10/2022
Proceedings: Notice of Filing Proposed Exhibits filed (exhibits not available for viewing).
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Date: 03/02/2022
Proceedings: Notice of Appearance (James Burkhart) filed.
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Date: 02/25/2022
Proceedings: Petitioner's Answers to Respondent's First Set of Interrogatories filed.
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Date: 01/26/2022
Proceedings: Order Granting Continuance and Rescheduling Hearing by Zoom Conference (hearing set for March 17, 2022; 9:00 a.m., Eastern Time).
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Date: 01/13/2022
Proceedings: Petitioner's Motion for Continuance of February 3, 2022 Hearing filed.
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Date: 01/11/2022
Proceedings: Notice of Appearance (Maria Santi) filed.
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Date: 01/03/2022
Proceedings: Amended Notice of Hearing by Zoom Conference (hearing set for February 3, 2022; 10:00 a.m., Eastern Time).
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Date: 12/28/2021
Proceedings: Order of Pre-hearing Instructions.
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Date: 12/27/2021
Proceedings: Order on Prehearing Conference.
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Date: 12/22/2021
Proceedings: Notice of Service of Respondent's First Set of Interrogatories filed.
PDF:
Date: 12/22/2021
Proceedings: Amended Respondent's Memorandum of Law on Burden and Standard of Proof filed.
Date: 12/22/2021
Proceedings: CASE STATUS: Pre-Hearing Conference Held.
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Date: 12/22/2021
Proceedings: Respondent's Memorandum of Law on Burden and Standard of Proof filed.
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Date: 12/17/2021
Proceedings: Notice of Hearing by Zoom Conference (hearing set for February 3, 2022; 9:00 a.m., Eastern Time).
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Date: 12/15/2021
Proceedings: Respondent's Response to Initial Order filed.
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Date: 12/10/2021
Proceedings: Notice of Telephonic Pre-hearing Conference (set for December 22, 2021; 9:00 a.m., Eastern Time).
PDF:
Date: 12/07/2021
Proceedings: Initial Order.
Date: 12/02/2021
Proceedings: External Review Appeal Determination filed.  Confidential document; not available for viewing.
Date: 12/02/2021
Proceedings: Final Agency Action Letter filed.  Confidential document; not available for viewing.
Date: 12/02/2021
Proceedings: Request for Formal Administrative Hearing filed.  Confidential document; not available for viewing.
PDF:
Date: 12/02/2021
Proceedings: Agency referral filed.

Case Information

Judge:
ROBERT L. KILBRIDE
Date Filed:
12/02/2021
Date Assignment:
12/07/2021
Last Docket Entry:
06/16/2022
Location:
Miami, Florida
District:
Southern
Agency:
Department of Management Services
 

Counsels

Related Florida Statute(s) (3):