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PA Bulletin, Doc. No. 04-1668

NOTICES

Terry Cook; Prehearing

[34 Pa.B. 4989]

Appeal of Terry Cook under 40 P. S. §§ 991.2101--991.2193; UMPC Health Plan; Doc. No. HC04-08-016

   The proceedings in this matter will be governed by 2 Pa.C.S. §§ 501--508 and 701--704 (relating to the Administrative Agency Law), 1 Pa. Code Part II (relating to General Rules of Administrative Practice and Procedure) and any other relevant procedure provisions of law.

   A prehearing telephone conference initiated by the Administrative Hearings Office shall be conducted on October 5, 2004, at 11 a.m. Each party shall provide a telephone number to be used for the telephone conference to the Hearings Administrator on or before August 31, 2004. A date for a hearing shall be determined, if necessary, at the prehearing telephone conference.

   On or before September 21, 2004, Terry Cook shall file with the Administrative Hearings Office and serve upon Catrina Jackson, UPMC Health Plan, One Chatham Center, Pittsburgh, PA 15219 (or another representative entering an appearance in these proceedings) a statement: (1) containing a chronology of all medical provider visits, communications and referrals relative to the August 8, 2003, surgery, including names and dates; (2) containing a chronology of all communications Highmark Blue Cross/Blue Shield relative to the surgery; (3) identifying Terry Cook's primary care physician and the period of time the physician has been so; and (4) accompanied by all documentation identified in the chronologies. Failure to comply with this paragraph may cause a party to waive claims and/or defenses.

   On or before September 21, 2004, UPMC shall file and serve a statement: (1) containing a chronology of all communications with Terry Cook, his medical providers and Highmark Blue Cross/Blue Shield relative to the surgery which took place prior to the first level complaint submission in this matter; (2) accompanied by all documentation identified in the chronology; and (3) accompanied by plan documents applicable to Terry Cook. Failure to comply with this paragraph may cause a party to waive claims and/or defenses.

   Motions preliminary to those at the hearing, protests, petitions to intervene or notices of intervention, if any, must be filed on or before September 27, 2004, with the Hearings Administrator, Administrative Hearings Office, Capitol Associates Building, Room 200, 901 North Seventh Street, Harrisburg, PA 17102. Answer to petitions to intervene shall be filed on or before October 1, 2004.

   Persons with a disability who wish to attend the administrative hearing and require an auxiliary aid, service or other accommodation to participate in the hearing should contact Jeffrey Wallace, Agency Coordinator, (717) 787-4298.

M. DIANE KOKEN,   
Insurance Commissioner

[Pa.B. Doc. No. 04-1668. Filed for public inspection September 3, 2004, 9:00 a.m.]


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