Leon FL Administrative law, Appeals and Health insurance Law -- eLawyers

Alexander R. Boler

Visitors: 130

Bar #111374(FL) License for 11 years

Tallahassee FL

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Florida Laws: 106.28, 120.56, 120.569, 120.57, 120.595, 120.68, 125.72, 130.05, 14.28, 17.54, 409.901, 409.902, 409.908, 409.910, 409.9101, 409.911, 409.913, 414.39, 440.39, 46.021, 520.50, 549.10, 552.44, 559.01, 606.03, 624.155, 627.428, 627.727, 641.59, 660.42, 663.18, 682.12, 694.15, 7.53, 733.612, 766.118, 766.303, 766.316, 768.14, 768.21, 768.28, 768.81, 812.014, 90.202, 90.302, 90.304, 90.702, 90.703, 90.704, 910.10, 950.01

19-001923MTR DONNA L. FALLON, AS POWER OF ATTORNEY FOR ALICIA M. FALLON vs AGENCY FOR HEALTH CARE ADMINISTRATION (2019)

Division of Administrative Hearings, Florida Filed: Apr. 15, 2019

The issue to be decided is the amount to be paid by Petitioner to Respondent, Agency for Health Care Administration ("AHCA"), out of her settlement proceeds, as reimbursement for past Medicaid expenditures pursuant to section 409.910, Florida Statutes.Petitioner proved Respondent should be reimbursed for its Medicaid lien in a lesser amount than that calculated pursuant to section 409.910(11)(f)

18-003107MTR JESSICA N. TORESCO vs AGENCY FOR HEALTH CARE ADMINISTRATION (2018)

Division of Administrative Hearings, Florida Filed: Jun. 18, 2018

The issue is the amount payable to Respondent, Agency for Health Care Administration ("Respondent" or "AHCA"), in satisfaction of Respondent's Medicaid lien from a settlement received by Petitioner, from a third party, pursuant to section 409.910, Florida Statutes (2017).Petitioner proved that agency's Medicaid lien amount should be reduced.

19-001889MTR SONJA L. NICOLAS, AS PLENARY GUARDIAN FOR HER SON, CLAUDE ZAVIER NICOLAS, AN INCAPACITATED PERSON vs AGENCY FOR HEALTH CARE ADMINISTRATION (2019)

Division of Administrative Hearings, Florida Filed: Apr. 12, 2019

What amount of Petitioner’s malpractice settlement must be paid to Respondent, Agency for Health Care Administration (Agency), to satisfy the Agency’s $13,904.06 Medicaid Lien?1/Unrebutted evidence proved past medical expenses were 7.9% of Petitioner's damages. Therefore, AHCA can recover only 7.9% of Medicaid payments. Preponderance of the evidence is Petitioner's burden.

19-000519MTR ALIA L. JUAREZ, BY AND THROUGH HER PARENTS AND NATURAL GUARDIANS SANDRA PEREZ LUNA AND JOSE LUIS JUAREZ vs AGENCY FOR HEALTH CARE ADMINISTRATION (2019)

Division of Administrative Hearings, Florida Filed: Jan. 29, 2019

18-002361MTR JENNIFER PUZANSKAS vs AGENCY FOR HEALTH CARE ADMINISTRATION (2018)

Division of Administrative Hearings, Florida Filed: May 10, 2018

The issue to be decided is the amount to be paid by Petitioner to Respondent, Agency for Health Care Administration (Agency), out of her settlement proceeds as reimbursement for past Medicaid expenditures pursuant to section 409.910, Florida Statutes (2018).Petitioner established that AHCA entitled only to a lower amount of reimbursement for medicaid expenses.

18-003847MTR AMANDA L. BAKER, BY AND THROUGH HER PARENTS AND GUARDIANS, JEFFREY BAKER AND KAREN BAKER vs AGENCY FOR HEALTH CARE ADMINISTRATION (2018)

Division of Administrative Hearings, Florida Filed: Jul. 20, 2018

The issue to be decided is the amount to be paid by Petitioner to Respondent, Agency for Health Care Administration (Agency), out of her settlement proceeds, as reimbursement for past Medicaid expenditures pursuant to section 409.910, Florida Statutes.Petitioner proved that AHCA's Medicaid lien should be reduced to same ratio as the settlement is to the value of the claim.

16-003590MTR MICHAEL LEE SMATHERS, II vs AGENCY FOR HEALTH CARE ADMINISTRATION (2016)

Division of Administrative Hearings, Florida Filed: Jun. 24, 2016

On the merits, the issues for determination are, first, whether a lesser portion of Petitioner's total recovery from a third-party tortfeasor should be designated as recovered medical expenses than the share presumed by statute; if so, then the amount of Petitioner's recovery to which Respondent's Medicaid lien may attach must be determined. Before the merits may be addressed, however, it will be necessary to decide whether, in light of the recent judicial invalidation of portions of the Medicaid Third-Party Liability Act, an administrative remedy remains available to Petitioner.The recent judicial invalidation of portions of the Medicaid Third-Party Liability Act has eviscerated the administrative remedy previously available to Petitioner, depriving DOAH of jurisdiction to proceed; case dismissed.

18-001216MTR SANTOS O. RODRIGUEZ-GOMEZ, DECEASED, BY AND THROUGH ARMANDO RODRIGUEZ-GOMEZ, AS PERSONAL REPRESENTATIVE OF THE ESTATE OF SANTOS O. RODRIGUEZ-GOMEZ, AND THE SURVIVING CHILDREN OF SANTOS O. RODRIGUEZ-GOMEZ, ET AL vs AGENCY FOR HEALTH CARE ADMINISTRATION (2018)

Division of Administrative Hearings, Florida Filed: Mar. 06, 2018

The issue is the amount payable to Respondent, Agency for Health Care Administration ("Respondent" or "AHCA"), in satisfaction of Respondent's Medicaid lien from a settlement received by Petitioners, from a third party, pursuant to section 409.910, Florida Statutes (2016).Petitioner proved by a preponderence of the evidence that AHCA's Medicaid lien should be reduced by the same ratio as the settlement.

18-001844MTR SCOTT R. BROWN vs AGENCY FOR HEALTH CARE ADMINISTRATION (2018)

Division of Administrative Hearings, Florida Filed: Apr. 09, 2018

This matter concerns the amount of money to be reimbursed to the Agency for Health Care Administration for medical expenses paid on behalf of Scott R. Brown, a Medicaid recipient, following a settlement recovered from a third party.Based on the evidence in the record, $5,317.12 of Petitioner's total third-party recovery represents the portion of the settlement proceeds fairly attributable to past medical expenses, which may be paid to satisfy the Agency's Medicaid lien.

18-001995MTR KIMIKIA MOLINA vs AGENCY FOR HEALTH CARE ADMINISTRATION (2018)

Division of Administrative Hearings, Florida Filed: Apr. 16, 2018

The issue for determination is the amount Petitioner, Kimikia Molina, must pay to Respondent, Agency for Health Care Administration (the Agency or AHCA), out of her settlement proceeds as reimbursement for past Medicaid expenditures pursuant to section 409.910, Florida Statutes (2017).1/ More specifically, it must be determined whether Petitioner owes the default amount, $41,250, pursuant to section 409.910(11)(f); and, if not, what portion of her $110,000 settlement proceeds is due to AHCA.Petitioner did not prove that the agency's Medicaid lien amount should be reduced. The agency is awarded the full amount of the undisputed lien amount it held for Medicaid payments made on behalf of Petitioner.