Brevard FL Adoption, Appeals and Government Lawyers

13-004113BID CARE ACCESS PSN, LLC vs AGENCY FOR HEALTH CARE ADMINISTRATION (2013)

Division of Administrative Hearings, Florida Filed: Oct. 17, 2013

The issues in this bid protest are whether, in making the decision to award Intervenor Prestige Health Choice, LLC ("Prestige"), a contract to provide Medicaid managed medical assistance services as a provider service network in Region 11 (covering Miami-Dade and Monroe Counties), Respondent Agency for Health Care Administration ("AHCA") acted contrary to a governing statute, rule, or solicitation specification; and, if so, whether such action was clearly erroneous, contrary to competition, arbitrary, or capricious. (In this protest, Petitioner Care Access PSN, LLC ("Care Access"), challenges AHCA's intended award to Prestige in Region 11, and only that award. Care Access does not seek to upset any other intended awards in Region 11 or in any other Region.)The agency's intended contract award, being contrary to the statutes and project specifications, is clearly erroneous and should be rescinded.

08-002575 SANDRA T. COLUMBUS vs MUTUAL OF OMAHA (2008)

Division of Administrative Hearings, Florida Filed: May 27, 2008

Whether Petitioner was an employee of Respondent's at the time of the alleged unlawful employment practices described in the employment discrimination complaint Petitioner filed with the Florida Commission on Human Relations (FCHR).Insurance agent was not an employee of insurance company whose products she had sold; agent`s employment discrimination complaint against company thus must be dismissed.

06-000555CON BAPTIST MEDICAL CENTER OF CLAY, INC. vs AGENCY FOR HEALTH CARE ADMINISTRATION AND ORANGE PARK MEDICAL CENTER, INC. (2006)

Division of Administrative Hearings, Florida Filed: Feb. 13, 2006

Whether the Certificate of Need (CON) applications filed by Baptist Medical Center of Clay, Inc. (Baptist Clay), St. Vincent's Medical Center, Inc. (SVMC), and Orange Park Medical Center, Inc. d/b/a Orange Park Medical Center (OPMC), for a new acute care hospital in Clay County, Agency for Health Care Administration (Agency or AHCA) acute care subdistrict 4-2, satisfy, on balance, the applicable statutory and rule review criteria sufficiently to warrant approval, and, if so, which of the three applications best meets the applicable statutory and rule review criteria for approval.On balance and in this comparative review hearing, St. Vincent`s Medical Center, Inc. proved that its proposed acute care hospital in Clay County should be approved over the other two applicants.

06-000563CON ST. VINCENT`S MEDICAL CENTER, INC. vs AGENCY FOR HEALTH CARE ADMINISTRATION (2006)

Division of Administrative Hearings, Florida Filed: Feb. 13, 2006

Whether the Certificate of Need (CON) applications filed by Baptist Medical Center of Clay, Inc. (Baptist Clay), St. Vincent's Medical Center, Inc. (SVMC), and Orange Park Medical Center, Inc. d/b/a Orange Park Medical Center (OPMC), for a new acute care hospital in Clay County, Agency for Health Care Administration (Agency or AHCA) acute care subdistrict 4-2, satisfy, on balance, the applicable statutory and rule review criteria sufficiently to warrant approval, and, if so, which of the three applications best meets the applicable statutory and rule review criteria for approval.On balance and in this comparative review hearing, St. Vincent`s Medical Center, Inc. proved that its proposed acute care hospital in Clay County should be approved over the other two applicants.

06-000843CON ORANGE PARK MEDICAL CENTER, INC., D/B/A ORANGE PARK MEDICAL CENTER vs AGENCY FOR HEALTH CARE ADMINISTRATION; BAPTIST MEDICAL CENTER OF CLAY, INC.; AND ST. VINCENT`S MEDICAL CENTER, INC. (2006)

Division of Administrative Hearings, Florida Filed: Mar. 09, 2006

Whether the Certificate of Need (CON) applications filed by Baptist Medical Center of Clay, Inc. (Baptist Clay), St. Vincent's Medical Center, Inc. (SVMC), and Orange Park Medical Center, Inc. d/b/a Orange Park Medical Center (OPMC), for a new acute care hospital in Clay County, Agency for Health Care Administration (Agency or AHCA) acute care subdistrict 4-2, satisfy, on balance, the applicable statutory and rule review criteria sufficiently to warrant approval, and, if so, which of the three applications best meets the applicable statutory and rule review criteria for approval.On balance and in this comparative review hearing, St. Vincent`s Medical Center, Inc. proved that its proposed acute care hospital in Clay County should be approved over the other two applicants.

04-001540RP AIU INSURANCE COMPANY, AMERICAN HOME ASSURANCE COMPANY, AMERICAN INTERNATIONAL SOUTH INSURANCE COMPANY, ET AL. vs DEPARTMENT OF FINANCIAL SERVICES, OFFICE OF INSURANCE REGULATION (2004)

Division of Administrative Hearings, Florida Filed: Apr. 22, 2004

Whether proposed Rule 69O-170.013(7), Florida Administrative Code, involving insurance coverage by property and casualty insurers under the Terrorism Risk Insurance Act of 2002, meets all procedural and substantive requirements so as to be a valid exercise of delegated legislative authority.Proposed Rule 690-17O.013(7), Florida Administrative Code, is invalid pursuant to Sections 120.52(8)(a), 120.52(8)(b), 120.52(8)(d), and 120.52(8)(e), Florida Statutes.

04-000155 AIU INSURANCE COMPANY, AMERICAN HOME ASSURANCE COMPANY, BIRMINGHAM FIRE INSURANCE COMPANY OF PENNSYLVANIA, COMMERCE AND INDUSTRY INSURANCE COMPANY, GRANITE STATE INSURANCE COMPANY, ET AL. vs DEPARTMENT OF FINANCIAL SERVICES, OFFICE OF INSURANCE REGULATION (2004)

Division of Administrative Hearings, Florida Filed: Jan. 14, 2004

The issues are as follows: (a) whether Respondent's disapproval of Petitioners' terrorism rates for workers' compensation insurance (workers' comp) under the Terrorism Risk Insurance Act of 2002, Public Law 101-297, 116 U.S.C. Section 2322 (TRIA) is based on an invalid agency statement of general applicability, which has not been adopted as a rule pursuant to Section 120.54, Florida Statutes (2003); (b) whether Petitioners, as members or subscribers of the National Council on Compensation Insurance (NCCI) were required to comply with Section 627.211, Florida Statutes (2003), and Florida Administrative Code Rule 69O-189.004; and (c) whether Petitioners' terrorism rate filing for the workers' comp line of business results in rates that are excessive or unfairly discriminatory.Petitioners did not meet their burden of proof that their terrorism rate was not excessive or unfairly discriminatory.

04-000163 AIU INSURANCE COMPANY, AMERICAN HOME ASSURANCE COMPANY, BIRMINGHAM FIRE INSURANCE COMPANY OF PENNSYLVANIA, COMMERCE AND INDUSTRY INSURANCE COMPANY, GRANITE STATE INSURANCE COMPANY, ET AL. vs DEPARTMENT OF FINANCIAL SERVICES, OFFICE OF INSURANCE REGULATION (2004)

Division of Administrative Hearings, Florida Filed: Jan. 14, 2004

The issues are as follows: (a) whether Respondent's disapproval of Petitioners' terrorism rates for workers' compensation insurance (workers' comp) under the Terrorism Risk Insurance Act of 2002, Public Law 101-297, 116 U.S.C. Section 2322 (TRIA) is based on an invalid agency statement of general applicability, which has not been adopted as a rule pursuant to Section 120.54, Florida Statutes (2003); (b) whether Petitioners, as members or subscribers of the National Council on Compensation Insurance (NCCI) were required to comply with Section 627.211, Florida Statutes (2003), and Florida Administrative Code Rule 69O-189.004; and (c) whether Petitioners' terrorism rate filing for the workers' comp line of business results in rates that are excessive or unfairly discriminatory.Petitioners did not meet their burden of proof that their terrorism rate was not excessive or unfairly discriminatory.

03-004477 AIU INSURANCE COMPANY, AMERICAN HOME ASSURANCE COMPANY, BIRMINGHAM FIRE INSURANCE COMPANY OF PENNSYLVANIA, COMMERCE AND INDUSTRY INSURANCE COMPANY, GRANITE STATE INSURANCE COMPANY, ET AL. vs DEPARTMENT OF FINANCIAL SERVICES, OFFICE OF INSURANCE REGULATION (2003)

Division of Administrative Hearings, Florida Filed: Nov. 26, 2003

Whether Respondent's proposed disapproval of Petitioners' burglary-theft rate filing (OIR File No. 03-11518) for insurance coverage under the Terrorism Risk Insurance Act of 2002, is based on an invalid agency statement of general applicability which has not been adopted as a rule pursuant to Section 120.54, Florida Statutes. Whether Petitioners' burglary-theft rate filing (OIR File No. 03-11518) for insurance coverage under the Terrorism Risk Insurance Act of 2002 meets all procedural and substantive requirements so as to be approved.Respondent`s non-rule policy, by which it rejected terrorism rate filing (TRIA), was invalid, but the insurer was unable to prove-up the requested rate per statute.

00-004162BID BRIDGEWAY CENTER, INC., AND FOSTER AMERICA, D/B/A MANAGED FAMILY SERVICES vs DEPARTMENT OF CHILDREN AND FAMILY SERVICES (2000)

Division of Administrative Hearings, Florida Filed: Oct. 06, 2000

The issues are whether Respondent’s decision to disqualify Petitioner’s response to an invitation to negotiate was clearly erroneous, contrary to competition, arbitrary, or capricious and whether Respondent’s decision not to disqualify Intervenor’s response to the same invitation to negotiate was clearly erroneous, contrary to competition, arbitrary, or capricious.Regarding an invitation to negotiate, Protestor failed to prove by a preponderance of the evidence that Agency improperly disqualified Protestor`s response or improperly failed to disqualify Intervenor`s response.

Kelly A Cruz-Brown