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AVANTE, INC., D/B/A AVANTE AT INVERNESS; AVANTE VILLA AT JACKSONVILLE BEACH; AVENTE AT BOCA RATON; AVANTE AT LEESBURG; AND AVANTE AT LAKE WORTH vs AGENCY FOR HEALTH CARE ADMINISTRATION, 99-000258 (1999)

Court: Division of Administrative Hearings, Florida Number: 99-000258 Visitors: 20
Petitioner: AVANTE, INC., D/B/A AVANTE AT INVERNESS; AVANTE VILLA AT JACKSONVILLE BEACH; AVENTE AT BOCA RATON; AVANTE AT LEESBURG; AND AVANTE AT LAKE WORTH
Respondent: AGENCY FOR HEALTH CARE ADMINISTRATION
Judges: LARRY J. SARTIN
Agency: Agency for Health Care Administration
Locations: Tallahassee, Florida
Filed: Jan. 15, 1999
Status: Closed
Recommended Order on Tuesday, June 13, 2000.

Latest Update: Jan. 16, 2001
Summary: The issue in this case is whether a petition filed by Petitioner challenging Medicaid audit adjustments suggested by Respondent should be accepted pursuant to the doctrine of equitable tolling.Petitioner proved that a late-filed petition challenging a Medicaid audit should be accepted under the doctrine of excusable neglect.
99-0258REMAND.PDF

STATE OF FLORIDA

DIVISION OF ADMINISTRATIVE HEARINGS


AVANTE, INC., d/b/a, AVANTE ) AT INVERNESS, AVANTE VILLA AT ) JACKSONVILLE BEACH, AVANTE AT ) BOCA RATON, AVANTE AT LEESBURG, ) and AVANTE AT LAKE WORTH, )

)

Petitioner, )

)

vs. ) Case No. 99-0258

)

AGENCY FOR HEALTH CARE )

ADMINISTRATION, )

)

Respondent. )

)


SUPPLEMENTAL RECOMMENDED ORDER ON REMAND


A Recommended Order was entered in this case on December 23, 1999. On or about May 12, 2000, Respondent remanded this case by Order of Remand for the limited purpose of providing "a conclusion on whether the facts established by [Petitioner] are sufficient to invoke the doctrine of 'equitable tolling.'" In response to the Order of Remand an Order Reopening File on Remand was entered May 22, 2000, reopening the file of the Division of Administrative Hearings.

It was noted in the Order Reopening File on Remand that Petitioner had filed a Motion for Entry of Amended Order in response to the Order of Remand in which it had addressed the issue for which Respondent had remanded this case. Petitioner also filed a copy of exceptions to the Recommended Order which had been filed by Respondent and Petitioner's response thereto.

Therefore, Respondent was given until June 5, 2000, to file a pleading addressing the issue for which this case had been reopened. On June 5, 2000, Respondent filed Agency Response to Order Re-Opening File on Remand.

After consideration of the responses of the parties to the Order Reopening File on Remand and the file in this case, the question posed by Respondent on remand is answered in the affirmative and the following amendments are hereby added to the Recommended Order entered in this case:

  1. Paragraph 48 is amended to read:


    48. The burden of proof, absent a statutory directive to the contrary, is on the party asserting the affirmative of the proceeding. Antel v. Department of Professional Regulation, 522 So.2d 1056 (Fla. 5th DCA 1988); Department of Transportation v. J.W.C. Co., Inc., 396 So. 2d 778 (Fla. 1st DCA 1981); and Balino v. Department of Health and Rehabilitative Services, 348 So. 2d 249 (Fla. 1st DCA 1977). Avante is asserting in this proceeding that the doctrine of equitable tolling should be applied in this case to excuse Avante's failure to timely file the Petition it filed with the Agency. The burden of proof in this proceeding was, therefore, on Avante.

  2. Paragraph 49 is amended to read:


    49. The doctrine of equitable tolling has been approved by the Supreme Court of Florida in Machules v. Department of Administration, 523 So. 2d 1132 (Fla. 1988). The Court ruled that the doctrine may be applied to "permit under certain circumstances the filing of a lawsuit that otherwise would be barred by a limitations period." Id. at 1133-34. The Court addressed the circumstances when the doctrine may be applied: "when the plaintiff has been misled or lulled into inaction, has in some extraordinary way been prevented from asserting his rights, or has timely asserted his rights mistakenly in the wrong forum." [Emphasis added]. Id. at 1133-34. In applying the doctrine, the emphasis is on "the plaintiff's excusable

    ignorance of the limitations period and on [the] lack of prejudice to the defendant." Id. at 1134 (quoting from Naton v. Bank of California, 649 F.2d 691, 696 (9th Cir. 1981), quoted in Cocke v. Merrill Lynch & Co., 817 F.2d 1559, 1561 (11th Cir. 1987).


  3. Paragraph 54 is amended to read:


    54. As in Plotkin and Marshall Davis, Ms. Beloat, contrary to her duties and responsibilities, failed to keep Avante informed of the audit results, in particular the Notice Letters. While the Courts in Plotkin and Marshall Davis used the terms "excusable neglect" rather than "equitable tolling," it is clear that the Courts considered the actions of the employees in those cases to constitute the type of "extraordinary" circumstances which the Court in Machules considered necessary to apply the doctrine of equitable tolling. As a consequence, it is concluded that Ms. Beloat's actions justify the application of the doctrine of equitable tolling in this case to Avante's failure to respond timely to the Notice Letters.

  4. Paragraph 58 is amended to read:


    58. Based upon the foregoing, it is concluded that the doctrine of equitable tolling as approved by the Supreme Court in Machules applies in this case.


  5. Finally, the recommendation contained in the Recommended Order is amended to read as follows:

RECOMMENDED that a final order be entered by the Agency for Health Care Administration finding that the doctrine of equitable tolling applies and accepting the Petition for Formal Hearing filed by Avante, Inc.

DONE AND ENTERED this 13th day of June, 2000, in Tallahassee, Leon County, Florida.



LARRY J. SARTIN

Administrative Law Judge

Division of Administrative Hearings The DeSoto Building

1230 Apalachee Parkway

Tallahassee, Florida 32399-3060

(850) 488-9675 SUNCOM 278-9675

Fax Filing (850) 921-6847 www.doah.state.fl.us


Filed with the Clerk of the Division of Administrative Hearings this 13th day of June, 2000.


COPIES FURNISHED:


Sam Power, Agency Clerk

Agency for Health Care Administration 2727 Mahan Drive, Suite 3431

Fort Knox Building III Tallahassee, Florida 32308


Julie Gallagher, General Counsel Agency for Health Care Administration 2727 Mahan Drive, Suite 3431

Fort Knox Building III Tallahassee, Florida 32308


Samuel J. Morley, Esquire Susan L. Turner, Esquire Holland & Knight, LLP Post Office Box 810

Tallahassee, Florida 32302-0810


Steven A. Grigas, Senior Attorney Agency for Health Care Administration 2727 Mahan Drive, Suite 3431

Fort Knox Building III Tallahassee, Florida 32308


Docket for Case No: 99-000258
Issue Date Proceedings
Jan. 16, 2001 Mandate filed.
Jan. 16, 2001 Opinion filed.
Jul. 27, 2000 Petition for Review of Non-Final Administrative Order (filed with the 1st DCA) filed.
Jul. 14, 2000 Letter to DOAH from DCA filed. DCA Case No. 1D00-2673.
Jul. 13, 2000 Petition for Review of Non-Final Administrative Order filed.
Jun. 13, 2000 Supplemental Recommended Order on Remand sent out. CASE CLOSED.
Jun. 05, 2000 Agency Response to order Re-Opening File on Remand filed.
May 22, 2000 Opinion (remanding case to DOAH for an evidentiary hearing)
May 22, 2000 Order Reopening File on Remand (1 FILE CASE REOPENED.)
May 22, 2000 Avante`s Notice of Filing Exceptions and Responses; Agency for Health Care Administration Exception to Recommended Order; Response to Agency for Health Care Administration`s Exceptions filed.
May 17, 2000 Avante`s Motion for Entry of Amended Recommended Order filed.
May 15, 2000 Order of Remand filed.
Dec. 23, 1999 Recommended Order sent out. CASE CLOSED. Hearing held 10/11/99.
Dec. 03, 1999 (Petitioner) Notice of Filing; Initial Brief and Appendix of Appellant; Amended Answer Brief of Appellee; Reply Brief of Appellant filed.
Dec. 03, 1999 Agency for Health Care Administration`s Proposed Recommended Order filed.
Dec. 03, 1999 Petitioner`s Proposed Recommended Order filed.
Nov. 30, 1999 Petitioners` Stipulated Motion for a Two-Day Extension of Time to File Proposed Recommended Order filed.
Nov. 01, 1999 Notice of Filing; (Volume 1 of 1) DOAH Court Reporter Final Hearing Transcript filed.
Oct. 11, 1999 CASE STATUS: Hearing Held.
Oct. 11, 1999 (S. Grigas, S. Morley) Prehearing Stipulation filed.
Oct. 04, 1999 (Petitioners) Notice of Taking Deposition Duces Tecum filed.
Sep. 30, 1999 (Petitioners) Notice of Taking Telephonic Deposition Duces Tecum filed.
Sep. 16, 1999 Notice of Service of Avante`s Answers to the Agency for Health Care Administration`s First set of Interrogatories and First Request for Production of Documents filed.
Sep. 16, 1999 Avante`s Answers to the Agency`s First set of Interrogatories filed.
Sep. 09, 1999 (Petitioners) Notice of Taking Deposition Duces Tecum filed.
Jun. 28, 1999 (Respondent) Notice of Taking Deposition (filed via facsimile).
Jun. 21, 1999 (Respondent) Notice of Service (filed via facsimile).
Jun. 14, 1999 Third Notice of Hearing sent out. (hearing set for 10:00am; Tallahassee; 10/11/99)
Jun. 10, 1999 Motion for Continuance (Respondent) (filed via facsimile).
Apr. 27, 1999 Second Notice of Hearing sent out. (hearing set for 6/28/99; 10:00am; Tallahassee)
Apr. 27, 1999 Order Granting Joint Motion for Continuance sent out. (hearing cancelled)
Apr. 21, 1999 Stipulation and Joint Motion for Continuance filed.
Feb. 05, 1999 Notice of Hearing sent out. (hearing set for 5/4/99; 9:00am; Tallahassee)
Feb. 01, 1999 Joint Response to Initial Order filed.
Jan. 25, 1999 (1st DCA) Opinion dated 12/31/98 rec`d
Jan. 22, 1999 Initial Order issued.
Jan. 15, 1999 Notice; DCA Opinion; Petition for Formal Administrative Hearing; Final Order rec`d

Orders for Case No: 99-000258
Issue Date Document Summary
Dec. 27, 2001 Opinion
Jan. 12, 2001 Mandate
Jun. 13, 2000 Recommended Order
May 22, 2000 Opinion
May 12, 2000 Remanded from the Agency
Dec. 23, 1999 Recommended Order Petitioner proved that a late-filed petition challenging a Medicaid audit should be accepted under the doctrine of excusable neglect.
Source:  Florida - Division of Administrative Hearings

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