[sfmcfar]

Well, the saga continues. My appeal was denied by MAMSI, again using the "experimental" label. I haven't seen their formal response yet, but I received a "courtesy" call from their appeal "auditor" informing me of the decision. Here's an entertaining recap of the conversation:

Me: "Did you personally see my appeal?"
She: "Yes. My job is to ensure that MAMSI meets the guidelines for federal employees in their appeal process."
Me: "If that's your job, then please explain to me why MAMSI is choosing to violate the Federal Employee Health Benefits Plan regulations by labeling FDA-approved procedures as experimental, which was the basis for my appeal."
She: "I can't answer that. I'm not a medical person."
Me: "I'm not asking you a medical question. If you *really* did read my appeal, you would have read the regulation, which was included in the appeal. I'm simply asking you why MAMSI believes they don't have to comply with the regulations."
She: "You don't understand. I have no medical training."
Me: Sigh......

So, the next step is to appeal to the US Office of Personnel Management, which has given every indication that they'll reverse the decision if sufficient evidence is shown that I meet the FDA indications for use.

Fortunately, my back is in a fairly "quiet" period so I can probably wait the 60 days for OPM to respond to the appeal.

Onward...