Leon FL Insurance and Mediation Lawyers | Joseph G. Hern Jr. -- eLawyers

17-5131 ALEXI FERNANDEZ v. STATE OF FLORIDA (2019)

District Court of Appeal of Florida Filed: Aug. 23, 2019

NOT FINAL UNTIL TIME EXPIRES TO FILE REHEARING MOTION AND, IF FILED, DETERMINED IN THE DISTRICT COURT OF APPEAL OF FLORIDA SECOND DISTRICT ALEXI FERNANDEZ, ) a/k/a ALEXEI FERNANDEZ, ) ) Appellant, ) ) v. ) Case No. 2D17-5131 ) STATE OF FLORIDA, ) ) Appellee. ) ) Opinion filed August 23, 2019. Appeal from the Circuit Court for Hendry County; James D. Sloan, Judge. Howard L. Dimmig, II, Public Defender, and Megan Olson, Assistant Public Defender, Bartow, for Appellant. Ashley Moody, Attorney Genera..

17-003320MPI AGENCY FOR HEALTH CARE ADMINISTRATION vs ACCESS MENTAL SOLUTIONS, LLC (2017)

Division of Administrative Hearings, Florida Filed: Jun. 09, 2017

Whether certain employees of Respondent, who provided services to Medicaid recipients, met the prior work experience requirement to be certified as targeted case managers ("TCMs").1/ The nine disputed employees are identified in the Joint Prehearing Stipulation as Arian Melgarejo, Isis Lopez, Sadaiky Morejon, Karen Cuellar, Elisa Alonso Knapp, Ilineis Gonzalez Torres, Andres Gutierrez, Ana Sarai Llanes, and Berto Mirabal Lopez.AHCA failed to prove Respondent was overpaid for Medicaid charges for services provided by certain targeted case managers. Respondent's TCMs had the requisite pre-employment experience.

18-000492MPI AGENCY FOR HEALTH CARE ADMINISTRATION vs HOSPICE OF THE FLORIDA SUNCOAST, D/B/A SUNCOAST HOSPICE (2018)

Division of Administrative Hearings, Florida Filed: Jan. 30, 2018

The issues are (1) whether the Agency for Health Care Administration (AHCA) is entitled to recover certain Medicaid payments that it made to Respondent, Hospice of the Florida Suncoast, Inc., d/b/a Suncoast Hospice (Suncoast), pursuant to section 409.913(11), Florida Statutes, for hospice services provided during the audit period, September 1, 2009, through December 31, 2012; and (2) if overpayments were made, the amount of sanctions, if any, that should be imposed against Suncoast pursuant to section 409.913(15) through (17).AHCA established that 36 patients not qualified for hospice care. Provider required to repay overpayments and fine imposed.

18-005269MPI AGENCY FOR HEALTH CARE ADMINISTRATION vs MARY CECILIA CROSBY, D.D.S. (2018)

Division of Administrative Hearings, Florida Filed: Oct. 03, 2018

Whether during the relevant audit period, Respondent, Mary Cecilia Crosby, D.D.S. ("Dr. Crosby"), an oral and maxillofacial surgeon, was overpaid for services that, in whole or in part, were not covered by Medicaid, were not medically necessary, were improperly coded, or were insufficiently documented; and, if so, in what amount and what is the appropriate penalty.Petitioner proved by a preponderance of the evidence that Respondent was overpaid; a fine, sanctions imposed by statute and costs imposed by statute, shall be paid.

17-005904MPI AGENCY FOR HEALTH CARE ADMINISTRATION vs FERNANDO V. DE LA CRUZ (2017)

Division of Administrative Hearings, Florida Filed: Oct. 27, 2017

Pursuant to section 409.913(15), (16), and (17), Florida Statutes; Florida Administrative Code rule 59G-9.070; and the Final Audit Report issued on November 17, 2015 (FAR), the issues are whether Petitioner overpaid Medicaid reimbursements to Respondent during the audit period of January 1, 2011, through February 28, 2014 (Audit Period), and, if so, the amount of the total overpayments; whether Petitioner may impose a fine against Respondent and, if so, the amount of the fine; and whether Petitioner may recover costs from Respondent and, if so, the amount of the costs.Pet. proved overpayments of Medicaid claims for 35 patients during audit period & may extend this total to all claims during audit period. Pet may impose fine of lesser of $100 per violation re 35 patients or 5% of extended overpayment.

17-000130MPI AGENCY FOR HEALTH CARE ADMINISTRATION vs OCTAVIO J. CARRENO, M.D. (2017)

Division of Administrative Hearings, Florida Filed: Jan. 11, 2017

Whether Octavio J. Carreno, M.D. ("Respondent" or "Dr. Carreno"), is liable to the Agency for Health Care Administration ("AHCA," "Agency," or "Petitioner") for an overpayment in the amount of $121,641.42 for certain claims for services during the audit period of January 1, 2012, through December 31, 2014, that in whole or in part were not covered by Medicaid. Whether Respondent is liable to Petitioner for a sanction in the amount of $24,328.28 pursuant to Florida Administrative Code Rule 59G-9.070(7)(e). Whether Respondent is liable to Petitioner for Petitioner's incurred investigative, legal, and expert witness costs, which Petitioner contends it is entitled to recover pursuant to section 409.913(23)(a), Florida Statutes (2014).Based on the FAR and evidence presented at the hearing, AHCA proved, for some claims, that Respondent was obligated to reimburse the agency for Medicaid overpayments made during the audit period. For other claims, no reimbursement was due.

16-004735MPI AGENCY FOR HEALTH CARE ADMINISTRATION vs ASON MAXILLOFACIAL SURGERY, P.A. (2016)

Division of Administrative Hearings, Florida Filed: Aug. 19, 2016

Whether the Agency for Health Care Administration (Petitioner or AHCA) is entitled to recover: certain Medicaid payments made to Respondent, Ason Maxillofacial Surgery, P.A., pursuant to section 409.913(11), Florida Statutes (2016); an amount of sanctions imposed pursuant to section 409.913(15); and the amount of any investigative, legal, and expert witness costs that AHCA incurred pursuant to section 409.913(23).Petitioner proved by a preponderance of the evidence that Respondent was overpaid; a fine, sanctions imposed by statute and costs imposed by statute, shall be paid.

1959 Hawke v. Broward Nat. Bank of Fort Lauderdale (1969)

District Court of Appeal of Florida Filed: Mar. 27, 1969 Citations: 220 So. 2d 678

220 So. 2d 678 (1969) John R. HAWKE and Jean Hawke, Appellants, v. BROWARD NATIONAL BANK OF FORT LAUDERDALE, H.G. Coleman and Arthur Saarinen, Appellees. No. 1959. District Court of Appeal of Florida. Fourth District. March 27, 1969. *679 Henry L. Kaye, of Simons & Schlesinger, Hollywood, for appellants. K. Odel Hiaasen, of McCune, Hiaasen, Crum & Ferris, Fort Lauderdale, for appellees. PER CURIAM. Plaintiffs appeal from a summary judgment dismissing Counts I and II of their complaint; and from a..

5D08-468 CS v. Department of Children and Families (2008)

District Court of Appeal of Florida Filed: Jul. 01, 2008 Citations: 985 So. 2d 547

985 So. 2d 547 (2008) C.S. v. DEPARTMENT OF CHILDREN AND FAMILIES. No. 5D08-468. District Court of Appeal of Florida, Fifth District. July 1, 2008. Decision without published opinion. Affirmed.

5D07-781 Edwards v. State (2007)

District Court of Appeal of Florida Filed: Aug. 15, 2007 Citations: 962 So. 2d 918

962 So. 2d 918 (2007) EDWARDS v. STATE. No. 5D07-781. District Court of Appeal of Florida, Fifth District. August 15, 2007. Decision without published opinion. Affirmed.

Joseph G. Hern Jr.