Leon FL Lawyers | Julia Patricia Forrester -- eLawyers

01-000024 MORRIS SHELKOFSKY vs DEPARTMENT OF MANAGEMENT SERVICES, DIVISION OF STATE GROUP INSURANCE (2001)

Division of Administrative Hearings, Florida Filed: Jan. 04, 2001

Whether Petitioner is entitled to receive a refund of insurance premiums paid to Respondent.Petitioner paid Consolidated Omnibus Budget Reconciliation Act premiums. Subsequently, he became permanently eligible for military health care and demanded return of his premiums. Held: he was not entitled to a refund.

02-004561 JUNE SLOTE vs DEPARTMENT OF MANAGEMENT SERVICES, DIVISION OF STATE GROUP INSURANCE (2002)

Division of Administrative Hearings, Florida Filed: Nov. 22, 2002

Whether Petitioner's claim against her state group health insurance company for services related to a Magnetic Resonance Imaging examination (MRI) should be granted or denied.Magnetic Resonance Imaging examination was not a covered procedure under the state group health insurance plan.

02-003116 MARIANNE FAHLE vs DEPARTMENT OF MANAGEMENT SERVICES, DIVISION OF STATE GROUP INSURANCE (2002)

Division of Administrative Hearings, Florida Filed: Aug. 07, 2002

The issue presented for decision in this case is whether the Department of Management Services properly denied medical insurance reimbursement to Marianne Fahle for EDTA chelation therapy services provided to her husband, John Fahle.Insurance administrator for state group health plan properly denied coverage for chelation therapy for arteriosclerosis as "experimental or investigational" under policy terms.

01-001804 SARAH C. NUDING vs DEPARTMENT OF MANAGEMENT SERVICES, DIVISION OF STATE GROUP INSURANCE (2001)

Division of Administrative Hearings, Florida Filed: May 08, 2001

The issue in this case is whether the expenses incurred by Petitioner incident to admission to Town & Country Hospital on December 11, 1999, resulted from an intentional self-inflicted injury, to wit: attempted suicide, and are therefore excluded from coverage under the State of Florida Employees Group Health Self Insurance Plan.Petitioner contested Blue Cross Blue Shields` refusal to pay hospital bill resulting from Baker Act admission due to suicide attempt. State of Florida Employees Group Health Self Insurance Plan excluded self-inflicted injury and resulting treatment.

01-001902CVL MICHAEL L. CONE AND CONE CONSTRUCTORS, INC. vs DEPARTMENT OF MANAGEMENT SERVICES (2001)

Division of Administrative Hearings, Florida Filed: May 15, 2001

The issue is whether Petitioner, Michael L. Cone, a convicted felon, should be placed on the convicted vendor list as defined in Section 287.133(1)2(c), Florida Statutes.

00-003553RU MEDIMPACT HEALTHCARE SYSTEMS, INC. vs DEPARTMENT OF MANAGEMENT SERVICES (2000)

Division of Administrative Hearings, Florida Filed: Aug. 28, 2000

Whether the Department of Management Services ("DMS") or the ("Department") has an unpromulgated rule which states, in effect, that the Department will select the solicitation procurement method known as an Invitation to Negotiate when it is in the Department's best interests to do so even if rule requirements for the selection have not been met? Whether the statement contained in the Invitation to Negotiate (ITN Number-DSGI 00-001) issued in April 2000 by the Division of State Group Insurance ("DSGI") for the purchase of pharmacy benefits management services to the effect that "a late-submitted offer to negotiate will be returned unopened" is an unpromulgated rule? Whether, although not pled, the Petitioner proved at final hearing the existence of other unpromulgated rules?Statements contrary to agency rules are not statements of general applicability. They are statements with no applicability.

00-003841 KENNETH E. GESSER vs DEPARTMENT OF MANAGEMENT SERVICES, DIVISION OF STATE GROUP INSURANCE (2000)

Division of Administrative Hearings, Florida Filed: Sep. 15, 2000

Whether Petitioner's laser in situ keratomileusis (LASIK) surgery is a covered service for which he is entitled payment/reimbursement under the State of Florida's Self-Insured Group Health Insurance Program.State of Florida Self-Insured Group Insurance Plan does not cover LASIK eye surgery.

00-003900BID MEDIMPACT HEALTHCARE SYSTEMS, INC. vs DEPARTMENT OF MANAGEMENT SERVICES, DIVISION OF STATE GROUP INSURANCE (2000)

Division of Administrative Hearings, Florida Filed: Sep. 20, 2000

Among the many issues in Case No. 00-3900BID, there are three main issues: whether it was proper for the Division of State Group Insurance ("DSGI" or the "agency") to reject and return unopened the response of Petitioner MedImpact Healthcare Systems, Inc., to DSGI's Invitation to Negotiate (the "ITN") for pharmacy benefits management services? If not, and the response should have been accepted and opened, whether DSGI's selection of an ITN as the method for soliciting suppliers eligible to provide pharmacy benefits management services for DSGI is an issue properly in the case? Finally, whether Merck-Medco Managed Care L.L.C. ("MMMC") has standing to intervene in this proceeding?Division of State Group Insurance wrongly rejected a late-filed submission to an Invitation to Negotiate delivered late by Federal Express because of severe thunderstorms over Memphis, Tennessee.

99-004328 MOHSEN M. MILANI vs DEPARTMENT OF MANAGEMENT SERVICES, DIVISION OF STATE GROUP INSURANCE (1999)

Division of Administrative Hearings, Florida Filed: Oct. 13, 1999

The issue is whether Petitioner timely filed his request for claim form requesting reimbursement for certain covered expenses under the Florida Flexible Benefits Program--Reimbursement Plan.Petitioner proved that he timely submitted his claims form for benefits under the Florida Flexible Benefits Program--Reimbursement Plan.

93-005311RE MILDRED HENRY vs AGENCY FOR HEALTH CARE ADMINISTRATION (1993)

Division of Administrative Hearings, Florida Filed: Sep. 13, 1993

Whether Emergency Rule 10CER92-4 should be invalidated because it constitutes an invalid exercise of delegated legislative authority.Rule held in valid after enactment of statue dealing specifically with sub- ject matter.

Julia Patricia Forrester