United States District Court, M.D. Pennsylvania
MICHAEL V. PELLICANO, Plaintiff,
OFFICE OF PERSONNEL MANAGEMENT, INSURANCE OPERATIONS, Defendant
Order Filed: November 8, 2013
Decided: March 25, 2014.
Michael V Pellicano, Plaintiff, Pro se, Olyphant, PA.
For The Office of Personnel Management, Insurance Operations, Defendant: Mark E. Morrison, Office of the United States Attorney - Civil, Harrisburg, PA; Melissa A. Swauger, U.S. Attorney's Office, Harrisburg, PA.
JOEL H. SLOMSKY, J.
AND NOW, this 25th day of March 2014, upon consideration of the Complaint (Doc. No. 1), Plaintiff's Motion for Judgment (Doc. No. 61), Defendant's Motion to Dismiss and for Summary Judgment (Doc. No. 62), Defendant's Statement of Facts in Support of the Motion for Judgment (Doc. No. 63), Defendant's Brief in Opposition to Plaintiff's Motion for Judgment (Doc. No. 64), Plaintiff's Brief in Opposition to Defendant's Motion to Dismiss and for Summary Judgment (Doc. No. 65), the Report and Recommendation of United States Magistrate Judge Martin C. Carlson (Doc. No. 67), Plaintiff's Objections to the Report and Recommendation (Doc. No. 70), Defendant's Brief in Opposition to Plaintiff's Objections to the Report and Recommendation (Doc. No. 71), Plaintiff's Reply to Defendant's Brief in Opposition (Doc. No. 72), and in accordance with the Opinion of the Court issued this day, it is ORDERED as follows:
1. The Report and Recommendation of Magistrate Judge Carlson (Doc. No. 67) is APPROVED and ADOPTED.
2. Defendant's Motion for Summary Judgment (Doc. No. 62) is GRANTED.
3. Plaintiff's Motion for Judgment (Doc. No. 61) is DENIED.
4. The Clerk of Court shall close this case for statistical purposes.
Before the Court is a request for judicial review of an administrative decision by the Office of Personnel Management (" OPM" or " Defendant" ), an agency of the federal government. In 2008, pro se Plaintiff Michael Pellicano (" Plaintiff') purchased medical equipment and sought reimbursement through his primary insurance provider. The provider covered 65% of the cost, instead of the full 100% sought by Plaintiff. (Doc. No. 1 at 2.) As a federal employee, Plaintiff is enrolled in a health benefits plan under the Federal Employees Health Benefits Act (" FEHBA" ), 5 U.S.C. § 8901, et seq. In accordance with the FEHBA, Plaintiff appealed his insurance provider's coverage decision to OPM. On February 22, 2010, OPM decided that 65% coverage for the purchase of necessary medical equipment was appropriate under Plaintiff's plan and concurred with his primary insurance provider's decision to cover that amount. (Doc. No. 1 at 15.) OPM sent a letter to Plaintiff notifying him of the decision and advising him that if he disagreed with the decision then he " may file suit against [OPM] in [f]ederal court." (Id.)
On March 2, 2011, Plaintiff filed a Complaint against OPM in this Court, alleging that the agency had " breached fiduciary duties [and] was arbitrary and capricious in denying additional benefits." (Id. at 1.) Pursuant to M.D. Pa. Local Rule 73.1(d), the case was assigned to U.S. Magistrate Judge Martin C. Carlson and this Court. On November 22, 2011, OPM filed a motion to remand the proceedings to the administrative agency in order to develop a full and complete factual record. (Doc. No. 21.) After briefing, Judge Carlson issued a Report and Recommendation, recommending that the case be remanded to OPM for further proceedings. (Doc. No. 26.)
On April 12, 2012, over Plaintiff's ...