{"id":245537,"date":"2026-04-25T00:45:11","date_gmt":"2026-04-25T00:45:11","guid":{"rendered":"https:\/\/www.newsbeep.com\/us-fl\/245537\/"},"modified":"2026-04-25T00:45:11","modified_gmt":"2026-04-25T00:45:11","slug":"miami-patient-wins-oscar-health-legal-battle-over-treatment","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/us-fl\/245537\/","title":{"rendered":"Miami patient wins Oscar Health legal battle over treatment"},"content":{"rendered":"

\"Martin<\/p>\n

Martin Langesfeld and his father’s attorney, Maria T. Santi, of Health and Medicine Law Firm, held a press conference outside of the Osvaldo N. Soto Miami-Dade Justice Center in Miami on Friday, April 24, 2026., a day after Miami-Dade Circuit Court Judge Migna Sanchez-Llorens ruled in favor of his father, Pablo Langesfeld, a cancer patient whose health insurer refused to cover a recurring $48,500 cancer treatment that could save his life.<\/p>\n

Pedro Portal<\/p>\n

pportal@miamiherald.com<\/p>\n

Pablo Langesfeld faced off against a health giant \u2014 and won.<\/p>\n

\u201cThis was an extremely intense and painful battle,\u201d Pablo\u2019s son, Martin Langesfeld, told a group of reporters Friday outside the Osvaldo N. Soto Miami-Dade Justice Center in Miami.<\/p>\n

\u201cNo sick person in the hardest moment of their life should have to stand and fight in a courtroom with lawyers for their life,\u201d he added, describing the country\u2019s healthcare and health-insurance systems as \u201cflawed\u201d and in need of change.<\/p>\n

The news conference comes a day after Miami-Dade Circuit Judge Migna Sanchez-Llorens ordered Oscar Health Insurance to authorize and pay for Langesfeld\u2019s recurring $48,500 oral medication to treat his advanced pancreatic cancer. Oscar Health has up to 30 days to file an appeal.<\/p>\n

READ MORE: Miami judge sides with cancer patient, orders insurer to cover pricey treatment<\/a><\/p>\n

Oscar Health and its attorneys have not responded to an email that the Miami Herald sent Thursday asking for comments.<\/p>\n

\u201cThis is not just about me, it\u2019s about helping other people being able to get treatment,\u201d Pablo Langesfeld told the Miami Herald in a statement Friday.<\/p>\n

\"Pablo Pablo Langesfeld, right, who lost his daughter and son-in-law in the 2021 Champlain Towers South collapse in Surfside, stands with his son Martin outside the old Dade County Courthouse in Miami on Tuesday, April 7, 2026. Pablo Langesfeld, who is battling advanced pancreatic cancer, sued Oscar Health Insurance for denying coverage of a drug therapy that his doctors recommend, underscoring broader struggles over access to treatment Carl Juste cjuste@miamiherald.com <\/p>\n

The dispute began in December, when Langesfeld\u2019s in-network doctor prescribed him Avmapki Fakzynja Co Pack, an oral medication that has shown promising trial results<\/a> in patients with metastatic pancreatic cancer, \u201cdue to failed chemotherapy interventions\u201d against his Stage 4 pancreatic cancer. The drug therapy is approved by the U.S. Food and Drug Administration to be used for ovarian-cancer treatment and was granted an \u201corphan drug\u201d designation in 2024 to encourage research and testing against pancreatic cancer, the third-leading cause of cancer-related death in the country.<\/p>\n

Doctors sometimes use a combination of drugs<\/a> during cancer treatment, including drugs that are not approved for the type of cancer being treated, according to the National Cancer Institute. That\u2019s because \u201cmany cancer drugs are effective against more than one type of cancer,\u201d and the FDA \u201cusually does not approve combinations of chemotherapy\u201d because of how many possible combinations there are.<\/p>\n

Even so, patients like Langesfeld sometimes find their treatments denied by health insurers. In Langesfeld\u2019s case, Oscar Health repeatedly declined to cover the costly cancer-fighting drug therapy, arguing that the prescribed drug was not medically necessary or federally approved to treat his type of cancer.<\/p>\n

\"Martin Martin Langesfeld talks about his father\u2019s cancer battle outside of the Osvaldo N. Soto Miami-Dade Justice Center in Miami on Friday, April 24, 2026. Pedro Portal pportal@miamiherald.com <\/p>\n

Langesfeld, who has become known across South Florida for his family\u2019s memorial efforts to remember his daughter, son-in-law<\/a> and other victims of the Surfside building collapse, wasn\u2019t ready to give up without a fight. He took the insurer to court, with his attorneys arguing that Oscar Health was violating its own policies.<\/a><\/p>\n

On Thursday, the judge gave her verdict, describing parts of Oscar Health\u2019s policies, including their definition of \u201cmedically necessary,\u201d as ambiguous, noting that Florida law requires ambiguous insurance contracts to be interpreted in favor of the customer.<\/p>\n

The judge\u2019s decision comes several weeks after the jury ruled in favor of Langesfeld, answering \u201cyes\u201d on four out of five questions related to whether the prescribed drug therapy is appropriate to treat his aggressive cancer.<\/p>\n

Maria T. Santi, one of Langesfeld\u2019s attorneys, said this week\u2019s verdict could help other patients in similar situations get the treatment they need, noting that preauthorization denials have also increased during the past several years. It\u2019s a problem that she\u2019s hoping legislators will fix so patients like Langesfeld aren\u2019t locked out of potentially life-saving treatment options or dragged into lengthy legal battles.<\/p>\n

\"Martin Martin Langesfeld and his father’s attorney, Maria T. Santi, speak at the Osvaldo N. Soto Miami-Dade Justice Center in Miami on Friday, April 24, 2026. Pedro Portal pportal@miamiherald.com <\/p>\n

\u201cIt\u2019s not right that a health insurance company is acting like a doctor\u201d and is determining what a patient does and does not need when that\u2019s the job of the doctor, Santi said.<\/p>\n

Some changes might be on the horizon. Dozens of major health insurers, including Cigna, Aetna and United Healthcare, last year pledged to make fewer medical procedures require pre-authorization<\/a> and to speed up the review process. Langesfeld\u2019s son says more needs to be done.<\/p>\n

\u201cMy advice for families that are in similar situations, because this is a very common issue, is once an insurance company denies you two or three times, that\u2019s not the end,\u201d Martin Langesfeld said in response to a Miami Herald question.<\/p>\n

\u201cIf you are in a situation like we were, fight it, fight it because you can,\u201d he said.<\/p>\n


\n \"Profile
\n <\/a><\/p>\n

Michelle Marchante<\/a><\/p>\n

Miami Herald<\/p>\n

Michelle Marchante covers the pulse of healthcare in South Florida and also the City of Coral Gables. Before that, she covered the COVID-19 pandemic, hurricanes, crime, education, entertainment and other topics in South Florida for the Herald as a breaking news reporter. She recently won first place in the health reporting category in the 2025 Sunshine State Awards for her coverage of Steward Health\u2019s bankruptcy. An investigative series about the abrupt closure of a Miami heart transplant program led Michelle and her colleagues to be recognized as finalists in two 2024 Florida Sunshine State Award categories. She also won second place in the 73rd annual Green Eyeshade Awards for her consumer-focused healthcare stories and was part of the team of reporters who won a 2022 Pulitzer Prize for the Miami Herald\u2019s breaking news coverage of the Surfside building collapse. Michelle graduated with honors from Florida International University and was a 2025 National Press Foundation Covering Workplace Mental Health fellow and a 2020-2021 Poynter-Koch Media & Journalism fellow.\u00a0
\n Support my work with a digital subscription<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"Martin Langesfeld and his father’s attorney, Maria T. Santi, of Health and Medicine Law Firm, held a press…\n","protected":false},"author":2,"featured_media":245538,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[15],"tags":[225,227,226],"class_list":["post-245537","post","type-post","status-publish","format-standard","has-post-thumbnail","category-hialeah","tag-hialeah","tag-hialeah-headlines","tag-hialeah-news"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/us-fl\/wp-json\/wp\/v2\/posts\/245537","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/us-fl\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/us-fl\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-fl\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-fl\/wp-json\/wp\/v2\/comments?post=245537"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/us-fl\/wp-json\/wp\/v2\/posts\/245537\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-fl\/wp-json\/wp\/v2\/media\/245538"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/us-fl\/wp-json\/wp\/v2\/media?parent=245537"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-fl\/wp-json\/wp\/v2\/categories?post=245537"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-fl\/wp-json\/wp\/v2\/tags?post=245537"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}