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LAWRENCE ABELE vs DEPARTMENT OF MANAGEMENT SERVICES, DIVISION OF STATE GROUP INSURANCE, 20-000056 (2020)

Court: Division of Administrative Hearings, Florida Number: 20-000056 Visitors: 10
Petitioner: LAWRENCE ABELE
Respondent: DEPARTMENT OF MANAGEMENT SERVICES, DIVISION OF STATE GROUP INSURANCE
Judges: YOLONDA Y. GREEN
Agency: Department of Management Services
Locations: Tallahassee, Florida
Filed: Jan. 07, 2020
Status: Closed
Recommended Order on Thursday, May 14, 2020.

Latest Update: May 14, 2020
Summary: The issue to be determined in this proceeding is whether Petitioner is entitled to a refund of the costs paid for prescriptions for compound Midrin.Petitioner did not prove that he is entitled to reimbursement as his prescription for compound drug was not covered under the Prescription Drug Plan for State of Florida employees.
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STATE OF FLORIDA DEPARTMENT OF MANAGEMENT SERVICES


LAWRENCE ABELE,


Petitioner,

Final Order No.: DMS-20-0052

vs. DOAH Case No.: 20-0056


STATE OF FLORIDA,

DEPARTMENT OF MANAGEMENT SERVICES, DIVISION OF STATE GROUP INSURANCE,


Respondent.

/


FINAL ORDER


This matter comes before the Department of Management Services (“Department”) for entry of a Final Order in accordance with section 120.569(1), Florida Statutes.

On May 14, 2020, Yolanda Y. Green, Administrative Law Judge (“ALJ”), issued a Recommended Order recommending that the Department enter a Final Order denying Petitioner Lawrence Abele (“Mr.Abele”)’s request for reimbursement for a compounded medication prescription. Mr. Abele did not file exceptions to the Recommended Order. After a thorough review of the record, and being fully advised in the premises, the Department hereby makes the following findings of fact and conclusion of law:

FINDINGS OF FACTS


Following a thorough review of the record, the Findings of Fact set forth in the Recommended Order are hereby adopted in their entirety and are incorporated herein by reference.



Page 1 of 3


Filed September 8, 2020 1:43 PM Division of Administrative Hearings


CONCLUSIONS OF LAW


Following a thorough review of the record and applicable laws, the Conclusions of Law set forth in the Recommended Order are adopted in their entirety and are incorporated herein by reference.

It is hereby ORDERED AND ADJUDGED:


  1. The Recommended Order issued in this case is adopted and incorporated herein by reference;

  2. The Department’s decision denying Mr. Abele’s appeal is AFFIRMED; and


  3. This final Order shall become effective on the date of filing with the Department’s Agency Clerk.

DONE and ORDERED on this

8/26/2020 I 1:59 PM EDT



JONATHAN R. SATTER

Agency Secretary

Department of Management Services 4050 Esplanade Way, Suite 285

Tallahassee, Florida 32399


Copies Furnished:


841 Maderia Circle

Tallahassee, FL 32312

Lawrence Abele


Via Email: atya@comcast.net

Jacob Koffsky, Esquire Foley & Lardner LLP

2 South Biscayne Boulevard, Suite 1900

Miami, Florida 33131

Via Email: Jkoffsky@foley.com


Erica D. Moore, Assistant General Counsel Department of Management Services

4050 Esplanade Way, Suite 160

Tallahassee, Florida 32399-0950 Erica.Moore@dms.fl.gov


NOTICE OF RIGHT TO APPEAL


Unless expressly waived by a party such as in a stipulation or in other similar forms of settlement, any party substantially affected by this Final Order may seek judicial review by filing an original notice of appeal with the agency clerk of the Department of Management Services, and a copy, accompanied by the filing fees prescribed by law, with the clerk of the appropriate District Court of Appeal. The notice of appeal must be filed within thirty (30) days of rendition of this order, in accordance with Rule 9.110, Florida Rules of Appellate Procedure, and Section 120.68, Florida Statutes.

Certificate of Clerk:


Filed in the Office of the Agency

Clerk of the Department of Management Services on this 8/27/2020 I 10:39 AM EDT


Diane Wint Agency Clerk


Docket for Case No: 20-000056
Issue Date Proceedings
Sep. 08, 2020 Agency Final Order filed.
May 14, 2020 Recommended Order (hearing held March 17, 2020). CASE CLOSED.
May 14, 2020 Recommended Order cover letter identifying the hearing record referred to the Agency.
Apr. 24, 2020 Motion for Confidential Court Filing of Respondent's Amended Proposed Recommended Order (Motion to Determine Confidentiality of Document) filed.
Apr. 24, 2020 Respondent's Amended Proposed Final Order filed (confidential information, not available for viewing). 
 Confidential document; not available for viewing.
Apr. 24, 2020 Motion for Confidential Court Filing of Respondent's Proposed Recommended Order (Motion to Determine Confidentiality of Document) filed.
Apr. 24, 2020 Respondent's Proposed Final Order filed (medical information, not available for viewing). 
 Confidential document; not available for viewing.
Apr. 23, 2020 Petitioner's Proposed Recommended Order filed.
Apr. 14, 2020 Notice of Filing Transcript.
Apr. 13, 2020 Transcript of Proceedings (not available for viewing) filed.
Mar. 19, 2020 Certification of Oath or Affirmation & Verification of Identity of Witness for Respondent at Division of Administrative Hearing on March 17, 2020 filed.
Mar. 18, 2020 Certification of Oath or Affirmation & Verification of Identity of Witness for Respondent at Division of Administrative Hearing on March 17, 2020 (Adam Korn) filed.
Mar. 18, 2020 (Amended) Certification of Oath or Affirmation & Verification of Identity of Witness for Respondent at Division of Administrative Hearings on March 17, 2020 filed.
Mar. 17, 2020 CASE STATUS: Hearing Held.
Mar. 16, 2020 Order Granting Motion to Adopt Certfication of Oath Form.
Mar. 13, 2020 Respondent's Motion to Adopt Certification of Oaths & Verifications of Identity (with Form Attached) filed.
Mar. 13, 2020 Respondent's Motion to Adopt Certification of Oaths & Verifications of Identity filed.
Mar. 13, 2020 Certification of Oath or Affirmation & Verification of Identity of Witness for Respondent at Division of Administrative Hearing on March 17, 2020 (Dr. Anthony Arnett, M.D) filed.
Mar. 12, 2020 Respondent's Proposed Exhibits filed (exhibits not available for viewing).
Mar. 12, 2020 Amended Respondent's Motion for Telephonic Appearance of Witness filed.
Mar. 12, 2020 Respondent's Motion for Telephonic Appearance Of Witness filed.
Mar. 12, 2020 Amended Respondent's Witness and Exhibit Lists (as to Exhibit 12) filed.
Mar. 12, 2020 Respondent's Witness and Exhibit Lists filed.
Mar. 12, 2020 CASE STATUS: Pre-Hearing Conference Held.
Mar. 12, 2020 Notice of Appearance (Gayla Grant) filed.
Mar. 11, 2020 Amended Joint Pre-Hearing Stipulation (Track changes removed) filed.
Mar. 10, 2020 Joint Pre-Hearing Stipulation filed.
Mar. 10, 2020 Petitioner's Exhibits filed (medical information not available for viewing). 
 Confidential document; not available for viewing.
Mar. 09, 2020 Notice of Telephonic Pre-hearing Conference (set for March 12, 2020; 9:30 a.m.).
Mar. 09, 2020 Notice of Special Appearance (CVS Pharmacy, Inc.) filed.
Mar. 05, 2020 Order Allowing Testimony by Telephone.
Mar. 04, 2020 Respondent's Motion for Telephonic Appearance of Witnesses filed.
Feb. 28, 2020 Order on CVS Pharmacy, Inc.'s Motion to Limit Subpoena.
Feb. 26, 2020 CASE STATUS: Motion Hearing Held.
Feb. 19, 2020 Notice of Telephonic Motion Hearing (motion hearing set for February 26, 2020; 1:00 p.m.).
Feb. 18, 2020 CVS Pharmacy, Inc.'s Motion to Limit Subpoena Served by Petitioner Lawrence Abele filed.
Feb. 18, 2020 Notice of Service of Respondent's Ongoing Response to Petitioner's Discovery Request filed.
Feb. 14, 2020 CVS Pharmacy, Inc.'s Notice of Special Appearance filed.
Feb. 14, 2020 Notice of Appearance (Jacob Koffsky) filed.
Feb. 03, 2020 Order of Pre-hearing Instructions.
Feb. 03, 2020 Notice of Hearing (hearing set for March 17, 2020; 9:30 a.m.; Tallahassee).
Jan. 31, 2020 CASE STATUS: Status Conference Held.
Jan. 30, 2020 Notice of Telephonic Status Conference (status conference set for January 31, 2020; 10:00 a.m.).
Jan. 30, 2020 Joint Response to Initial Order filed.
Jan. 16, 2020 Order Granting Extension of Time.
Jan. 16, 2020 Respondent's Motion for Extension of Time to File Joint Response filed.
Jan. 07, 2020 Initial Order.
Jan. 07, 2020 Order Transferring Matter to the Division of Administrative Hearings filed.
Jan. 07, 2020 Notice of Continuation of Informal Hearing filed.
Jan. 07, 2020 Attachments from Informal hearing docket filed (medical information; not available for viewing). 
 Confidential document; not available for viewing.
Jan. 07, 2020 Petition for Informal Hearing filed.
Jan. 07, 2020 Agency action letter filed.
Jan. 07, 2020 Agency referral filed.

Orders for Case No: 20-000056
Issue Date Document Summary
Aug. 26, 2020 Agency Final Order
May 14, 2020 Recommended Order Petitioner did not prove that he is entitled to reimbursement as his prescription for compound drug was not covered under the Prescription Drug Plan for State of Florida employees.
May 14, 2020 Recommended Order Petitioner did not prove that he is entitled to reimbursement as his prescription for compound drug was not covered under the Prescription Drug Plan for State of Florida employees.
Source:  Florida - Division of Administrative Hearings

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