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Susan Sapoznikoff

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Florida Administrative Code: 59G-6.010

19-006584MPI AGENCY FOR HEALTH CARE ADMINISTRATION vs HOUR BLISS, INC. (2019)

Division of Administrative Hearings, Florida Filed: Dec. 11, 2019

Whether Respondent was overpaid $237,802.50 for services that in whole, or in part, are not covered by Medicaid because the services were performed by rendering providers who did not have the requisite education or work experience to meet the eligibility requirements in the Behavior Analysis Services Coverage Handbook (“BA Handbook”) to perform the services or for whom documentation was insufficient to determine eligibility; and, if so, the amount of the overpayment to be repaid, the amount of any fine to be imposed against Respondent, and the amount of any investigative, legal, and expert witness costs to be assessed against Respondent.Respondent was overpaid $237,802.50 for services that in whole or in part are not covered by Medicaid because the services were performed by providers who did not have the requisite education or work experience. Recommend repayment, sanctions, and costs.

19-003202 JOHN MILLER vs AGENCY FOR HEALTH CARE ADMINISTRATION (2019)

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

Whether the Agency for Health Care Administration abused its discretion when denying Petitioner’s request for exemption from disqualification to work in a position of special trust.Petitioner failed to prove that the Agency abused its discretion when denying Petitioner's request for exemption from disqualification to work in a position of special trust.

19-003666MPI AGENCY FOR HEALTH CARE ADMINISTRATION vs ZENITH PSYCHOLOGICAL SERVICES, INC. (2019)

Division of Administrative Hearings, Florida Filed: Jul. 10, 2019

The issues presented in this proceeding are: (1) whether, Petitioner, Agency for Health Care Administration, is entitled to repayment of an alleged Medicaid overpayment to Respondent, Zenith Psychological Services, Inc., and, if so, the amount of the overpayment to be repaid; (2) whether an administrative fine should be imposed against Respondent, and, if so, the amount of that fine; and (3) if warranted, the amount of any investigative, legal, and expert witness costs to be assessed against the Respondent.Petitioner established its entitlement to reimbursement for Medicaid overpayments made to Respondent, payment of administrative fine, and recovery of its costs as provided by statute.

19-001562 BRIDGET D. NELSON vs AGENCY FOR HEALTH CARE ADMINISTRATION (2019)

Division of Administrative Hearings, Florida Filed: Mar. 21, 2019

The issue is whether Respondent, Agency for Health Care Administration (“AHCA” or “the Agency”), discriminated against Petitioner, Bridget D. Nelson, now Levens (“Petitioner”), based upon her sex, race, or age, in violation of section 760.10, Florida Statutes (2017),1/ and/or whether the Agency retaliated against Petitioner for the exercise of protected rights under section 760.10.Petitioner failed to prove that her dismissal from employment was because of her sex, race, or age and failed to prove that any actions taken by the employer were in retaliation for her exercise of protected rights.

19-000124EXE RIQUEL GONZALEZ-SALCERIO vs AGENCY FOR HEALTH CARE ADMINISTRATION (2019)

Division of Administrative Hearings, Florida Filed: Jan. 07, 2019

Whether Petitioner, Riquel Gonzalez-Salcerio ("Dr. Gonzalez"), has disqualifying offenses under section 435.04(4), Florida Statutes; if so, whether Dr. Gonzalez has demonstrated rehabilitation by clear and convincing evidence; and, if so, whether Respondent, Agency for Health Care Administration's ("AHCA"), intended action to deny Dr. Gonzalez's request for an exemption from disqualification constitutes an abuse of discretion.Petitioner does not have disqualifying offenses. Even if he did, clear and convincing evidence demonstrates he is rehabilitated and that it would be an abuse of discretion to deny exemption.

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.

20-001337 JENNIFER GARCIA vs AGENCY FOR HEALTH CARE ADMINISTRATION (2020)

Division of Administrative Hearings, Florida Filed: Mar. 11, 2020

The issues in this case are whether Petitioner has provided clear and convincing evidence of rehabilitation from her disqualifying offense; and, if so, whether Respondent abused its discretion in denying Petitioner’s request for an exemption from disqualification from employment as a Medicaid provider.Petitioner established rehabilitation by clear and convincing evidence. The Agency for Health Care Administration's intended decision to deny the exemption was an abuse of discretion.

20-002884MPI AGENCY FOR HEALTH CARE ADMINISTRATION vs ABELLA YOSE CARE SERVICES, INC. (2020)

Division of Administrative Hearings, Florida Filed: Jun. 23, 2020

21-001350F AGENCY FOR HEALTH CARE ADMINISTRATION vs ABELLA YOSE CARE SERVICES, INC. (2021)

Division of Administrative Hearings, Florida Filed: Apr. 20, 2021

The issue for determination in this matter is the amount of costs, pursuant to section 409.913(23), Florida Statutes (2020), to be awarded to the Agency, the prevailing party in Case No. 20-2884MPI.As having prevailed in the underlying matter, the Agency is entitled to $17,715.11 as reasonable fees and costs associated with DOAH Case No. 20-2884MPI.