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  6. Joanne Barbara Erde
Joanne Barbara Erde
Joanne Barbara Erde
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Bar #588067(FL)     License for 38 years
Miami FL

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Related Laws :

USC: 42 U.S.C 1316, 42 U.S.C 1396a, 42 U.S.C 1396b

CFR: 42 CFR 40.255, 42 CFR 40.255, 42 CFR 40.255, 42 CFR 40.255, 42 CFR 431.200, 42 CFR 431.200, 42 CFR 431.200, 42 CFR 431.220, 42 CFR 438.400, 42 CFR 438.400, 42 CFR 438.400, 42 CFR 440.230, 42 CFR 440.230, 42 CFR 440.230, 42 CFR 440.255, 42 CFR 440.255, 42 CFR 440.255, 42 CFR 440.255, 42 CFR 447.253, 42 CFR 447.253, 42 CFR 447.253

Florida Laws: 1.01, 120.52, 120.536, 120.54, 120.56, 120.569, 120.57, 120.595, 120.68, 287.057, 409.901, 409.902, 409.903, 409.904, 409.905, 409.906, 409.907, 409.908, 409.9081, 409.912, 409.9128, 409.913, 409.9131, 409.919, 409.920, 409.975, 414.095, 445.024, 713.04

Florida Administrative Code: 59G-1.010, 59G-4.160, 59G-9.070, 65-2.042, 65-2.066, 65A-1.702, 65A-1.715

17-000559RP  SOUTHERN BAPTIST HOSPITAL OF FLORIDA, D/B/A BAPTIST MEDICAL CENTER OF NASSAU, SOUTHERN BAPTIST HOSPITAL OF FLORIDA, D/B/A, BAPTIST MEDICAL CENTER OF THE BEACHES, ET AL vs AGENCY FOR HEALTH CARE ADMINISTRATION  (2017)
Division of Administrative Hearings, Florida Filed: Jan. 23, 2017
The issues are whether proposed and existing Florida Administrative Code rules, both numbered 59G-6.030, are valid exercises of delegated legislative authority.Rule and proposed rule incorporating methodology for determining Medicaid outpatient hospital reimbursement rates were not invalid. Petitions denied.
17-000560RP  MIAMI BEACH HEALTHCARE GROUP, LTD., D/B/A AVENTURA HOSPITAL AND MEDICAL CENTER; HCA HEALTH SERVICES OF FLORIDA, INC., D/B/A BLAKE MEDICAL CENTER; GALENCARE, INC., D/B/A BRANDON REGIONAL HOSPITAL; TALLAHASSEE MEDICAL CENTER, INC., ET AL vs AGENCY FOR HEALTH CARE ADMINISTRATION  (2017)
Division of Administrative Hearings, Florida Filed: Jan. 23, 2017
The issues are whether proposed and existing Florida Administrative Code rules, both numbered 59G-6.030, are valid exercises of delegated legislative authority.Rule and proposed rule incorporating methodology for determining Medicaid outpatient hospital reimbursement rates were not invalid. Petitions denied.
14-004758RU  BAYFRONT MEDICAL CENTER, INC.; BETHESDA HEALTH, INC., D/B/A BETHESDA MEMORIAL HOSPITAL; CAPE MEMORIAL HOSPITAL, INC., D/B/A CAPE CORAL HOSPITAL; CGH HOSPITAL, LTD., D/B/A CORAL GABLES HOSPITAL, ET AL. vs AGENCY FOR HEALTH CARE ADMINISTRATION  (2014)
Division of Administrative Hearings, Florida Filed: Oct. 13, 2014
Is the practice of Respondent, Agency for Health Care Administration (Agency), limiting Medicaid reimbursement for services provided to undocumented aliens determined by the Department of Children and Families (DCF) to be eligible for Medicaid services for the duration of a medical emergency an "agency statement of general applicability that implements, interprets, or prescribes law or policy or describes the procedure or practice requirements of an agency"1/ that section 120.54, Florida Statutes (2014),2/ requires the Agency to adopt as a rule? Are Agency rules 59G-4.160(2) and 59G-5.020 invalid because they exceed the Agency's delegated authority and contravene the statute which the rule implements?3/ & 4/Hospitals did not prove AHCA reliance on statues and rules was unadopted rule. Rules 59G-4.160(2) and 59G-5.020 were not invalid for exceeding authority or vagueness.
12-002757RU  BAYFRONT MEDICAL CENTER, INC.; CAPE MEMORIAL HOSPITAL, INC., D/B/A CAPE CORAL HOSPITAL; CGH HOSPITAL, LTD., D/B/A CORAL GABLES HOSPITAL; DELRAY MEDICAL CENTER, INC., D/B/A DELRAY MEDICAL CENTER; LEE MEMORIAL HEALTH SYSTEM; ET AL. vs AGENCY FOR HEALTH CARE ADMINISTRATION  (2012)
Division of Administrative Hearings, Florida Filed: Aug. 15, 2012
What is the amount of reasonable attorney’s fees and taxable costs Respondent, Agency for Health Care Administration (Agency), must pay Petitioners, Bayfront Medical Center, Inc., et al (Hospitals), for this unpromulgated rule challenge before the Division of Administrative Hearings (Division). What is the amount of reasonable attorney’s fees the Agency must pay Hospitals for appellate proceedings before the First District Court of Appeal in this matter?A $365,351 fee for unpromulgated rule challenge & $397,533.50 were reasonable. For junior lawyer hourly rate of $200 is reasonable; $425 reasonable for Sr. lawyer. If records do not have sufficient detail across-the-board reduction of hours is proper.
14-003606MPI  AGENCY FOR HEALTH CARE ADMINISTRATION vs CAPE MEMORIAL HOSPITAL, INC., D/B/A CAPE CORAL HOSPITAL  (2014)
Division of Administrative Hearings, Florida Filed: Aug. 05, 2014
Whether the Agency for Health Care Administration (Petitioner) is entitled to recover certain Medicaid payments made to Cape Memorial Hospital, Inc., d/b/a Cape Coral Hospital (Respondent).Petitioner may receive Medicaid overpayment from provider.
15-003271MPI  AGENCY FOR HEALTH CARE ADMINISTRATION vs LEE MEMORIAL HEALTH SYSTEM, INC., D/B/A LEE MEMORIAL HEALTH SYSTEMS  (2015)
Division of Administrative Hearings, Florida Filed: Jun. 04, 2015
Petitioner presented evidence to support overpayment to Respondent.
14-004171MPI  AGENCY FOR HEALTH CARE ADMINISTRATION vs LEE MEMORIAL HEALTH SYSTEM, D/B/A LEE MEMORIAL HOSPITAL  (2014)
Division of Administrative Hearings, Florida Filed: Sep. 09, 2014
Whether the Agency for Health Care Administration (Agency or AHCA) is entitled to recover certain Medicaid funds paid to Lee Memorial Health System, d/b/a Lee Memorial Hospital (Respondent or Lee Memorial), for services provided to undocumented aliens: between January 1 through December 31, 2006, as alleged in AHCA’s Amended Final Audit Report, dated July 25, 2014 (DOAH Case 14-4171); and January 1 through December 31, 2007, as alleged in AHCA’s Final Audit Report, dated March 12, 2015 (DOAH Case 15-3271).Petitioner presented evidence to support overpayment to Respondent.
15-003876MPI  AGENCY FOR HEALTH CARE ADMINISTRATION vs LEE MEMORIAL HEALTH SYSTEM GULF COAST MEDICAL CENTER  (2015)
Division of Administrative Hearings, Florida Filed: Jul. 13, 2015
The issue for determination is whether an amount of up to $46,901.85, which Petitioner paid on behalf of eligible aliens for emergency hospital inpatient services that Respondent provided during the period from January 1, 2007, to December 31, 2007, constitutes an overpayment that Respondent must return, on the grounds that the services are not covered by Medicaid, despite having been included in claims of Respondent's that were prior authorized by Petitioner before payment.Sums paid on behalf of eligible aliens for emergency services provided by Respondent did not constitute an overpayment because the services were covered by Medicaid, as Petitioner had determined originally when it gave prior authorization to the claims.
10-002996RX  BAPTIST HOSPITAL, INC., BAY MEDICAL CENTER, HOLMES REGIONAL MEDICAL CENTER, INC., LEE MEMORIAL HEALTH SYSTEM, LIFEMARK HOSPITALS OF FLORIDA, INC., D/B/A PALMETTO GENERAL HOSPITAL, MUNROE REGIONAL MEDICAL CENTER, NORTH BROWARD HOSPITAL DISTRICT ET AL. vs AGENCY FOR HEALTH CARE ADMINISTRATION  (2010)
Division of Administrative Hearings, Florida Filed: Jun. 01, 2010
The issues in the case are whether certain provisions of the Florida Medicaid Hospital Services Coverage and Limitations Handbook (Handbook) that exclude non-emergent services rendered in the emergency room from covered Medicaid outpatient services and require revenue Code 451 to be billed with CPT Code 99281 constitute an invalid exercise of delegated legislative authority within the meaning of Subsection 120.56(3), Florida Statutes (2010).1Amended as to the rules being challenged.
10-002997RU  BAPTIST HOSPITAL, INC.; BAY MEDICAL CENTER; HOLMES REGIONAL MEDICAL CENTER, INC.; LEE MEMORIAL HEALTH SYSTEM; LIFEMARK HOSPITALS OF FLORIDA, INC., D/B/A PALMETTO GENERAL HOSPITAL; MUNROE REGIONAL MEDICAL CENTER; NORTH BROWARD HOSPITAL DISTRICT, ET AL. vs AGENCY FOR HEALTH CARE ADMINISTRATION  (2010)
Division of Administrative Hearings, Florida Filed: Jun. 01, 2010
The issues in this case are whether the statement contained in Respondent's letter dated September 9, 1997 (1997 Letter), establishing a $24.00 payment for hospital outpatient services billed as revenue code 451 constitutes a rule as defined by Subsection 120.52(15), Florida Statutes (2010),1 and, if so, whether Respondent violated Subsection 120.54(1), Florida Statutes, by not adopting the statement in accordance with applicable rulemaking procedures.Statements in a 1997 letter constitute a rule and the statements were not promulgated as rules pursuant to Section 120.54, Florida Statutes.

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