Fil. ED
STATE OF FLORIDA AG l HC A
AGENCY FOR HEALTH CARE ADMI NIST RAfi 6 / L E RK
f zuoq AUG IO p I: Sb
STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,
vs.
Petitioner,
DOAH Case No.: 09-0724MPI PROVIDER NO.: 106416900 AHCA C.I. No.: 08-6184-000
PRESCRIPTION CENTERS, d/b/a COLONIAL DRUGS,
RENDITION NO.: AHCA-09- U(;OB -5-MDO
Respondent.
I
FINAL ORDER
THE PARTIES resolved all disputed issues and executed a settlement agreement, which is attached and incorporated by reference. The parties are directed to comply with the terms of the attached settlement agreement. Based on the foregoing, this file is CLOSED.
DONE AND ORDERED on this the ifl-- day of Tallahassee, Florida.
, 2009, in
Holly Benson, Secretary
Agency for Health Care Administration
Filed August 13, 2009 10:20 AM Division of Administrative Hearings.
Copies Furnished to:
Smita Amin and Dilip Patel Prescription Centers, LLC d/b/a Colonial Drugs
155 East New England Avenue Winter Park, Florida 32789
Kelly Bennett, Assistant General Counsel Agency for Health Care Administration (Interoffice)
Peter Williams, Inspector General Agency for Health Care Administration (Interoffice)
D. Kenneth Yon, Bureau Chief Medicaid Program Integrity (Interoffice)
Finance & Accounting (Interoffice)
CERTIFICATE OF SERVICE
I HEREBY CERTIFY that a true and correct copy of the foregoing was served to the
above named addresses by mail or interoffice mail this of
Auql-AJT,
2009.
<:S
Richard Shoop, Agency Clerk
Agency for Health Care Administration 2727 Mahan Drive, Bldg. 3, Mail Stop #3
Tallahassee, Florida 32308-5403
(850) 922-5873
2
/
SETTLEMENT AGREEMENT
STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION ("AHCA" or "the Agency"), and PRESCRIPTION CENTERS, d/b/a COLONIAL DRUGS,
("PROVIDER"), by and through the undersigned, hereby stipulates and agrees as follows:
This Agreement is entered into for the purpose of memorializing the final resolution of the matters set forth in this Agreement.
PROVIDER is a Medicaid provider (Medicaid Provider No. 106416900) in the State of Florida.
In a Final Agency Audit Report dated March 28, 2008, AHCA notified PROVIDER that review of Medicaid claims performed by Medicaid Program Integrity (MPI) indicated that, in its opinion, some claims in whole or in part were not covered by Medicaid and that an overpayment in the amount of $24,883.59 had been identified. Additionally, AHCA MPI imposed a fine in the amount of$5,500.00.
The PROVIDER requested an informal administrative hearing to dispute MPI's findings.
There appearing to be a specific dispute about material facts, the Agency requested the case be referred to the Division of Administrative Hearings ("DOAH'') for a formal hearing. The matter was referred to DOAH.
In order to resolve this matter without the need for formal administrative proceedings, PROVIDER and the AHCA expressly agree as follows:
AHCA agrees to accept the payment set forth herein in settlement of the issues arising from the MPI review.
PROVIDER agrees to make a single payment of thirty thousand three hundred eighty three dollars and fifty nine cents ($30,383.59), in full and complete settlement of all claims in this matter, to be made within forty five (45) days of the issuance of the Final Order adopting the settlement agreement. [PROVIDER is not precluded from making some or all of the payment early, so long as the full amount due is completely paid within this deadline].
PROVIDER and AHCA agree that full payment as set forth above will resolve and settle this case completely and release both parties from all liabilities arising from the findings in the audit referenced as C.I. No. 08-6184-000.
Payment shall be made to:
AGENCY FOR HEALTHCARE ADMINISTRATION
Medicaid Accounts Receivable Post Office Box 13749 Tallahassee, Florida 32317-3749
PROVIDER agrees that failure to pay any monies due and owing under the terms of this Agreement shall constitute PROVIDER'S authorization for the Agency, without further
notice, to withhold the total remaining amount due under the terms of this agreement from any monies due and owing to PROVIDER for any Medicaid claims.
AHCA reserves the right to enforce this Agreement under the laws of the State of Florida, the Rules of the Medicaid Program, and all other applicable rules and regulations.
This settlement does not constitute an admission of wrongdoing or error by either party with respect to this case or any other matter. In fact, while AHCA alleged administrative errors it does not allege any submission of false claims, or fraud in connection with this matter.
Each party shall bear its own attorneys' fees and costs, if any, except as set forth
herein.
The signatories to this Agreement, acting in a representative capacity, represent that they are duly authorized to enter into this Agreement on behalf of the respective parties.
This Agreement shall be construed in accordance with the provisions of the laws of Florida. Venue for any action arising from this Agreement shall be in Leon County, Florida.
This Agreement constitutes the entire agreement between PROVIDER and the AHCA, including anyone acting for, associated with or employed by them, concerning all matters and supersedes any prior discussions, agreements or understandings; there are no promises, representations or agreements between PROVIDER and the AHCA other than as set forth herein. No modification or waiver of any provision shall be valid unless a written amendment to the Agreement is completed and properly executed by the parties.
This is an Agreement of settlement and compromise, made in recognition that the parties may have different or incorrect understandings, information and contentions, as to facts and law, and with each party compromising and settling any potential correctness or
incorrectness of its understandings, information and contentions as to facts and law, so that no misunderstanding or misinformation shall be a ground for rescission hereof.
PROVIDER expressly waives in this matter its right to any hearing pursuant to sections 120.569 or 120.57, Florida Statutes, the making of findings of fact and conclusions of law by the Agency, and all further and other proceedings to which it may be entitled by law or rules of the Agency regarding this proceeding and any and all issues raised herein. PROVIDER further agrees that it shall not challenge or contest any Final Order entered in this matter which is consistent with the terms of this settlement agreement in any forum now or in the future available to it, including the right to any administrative proceeding, circuit or federal court action or any appeal.
This Agreement is and shall be deemed jointly drafted and written by all parties to it and shall not be construed or interpreted against the party originating or preparing it.
To the extent that any provision of this Agreement is prohibited by law for any reason, such provision shall be effective to the extent not so prohibited, and such prohibition shall not affect any other provision of this Agreement.
This Agreement shall inure to the benefit of and be binding on each party's successors, assigns, heirs, administrators, representatives and trustees.
All times stated herein are of the essence of this Agreement.
This Agreement shall be in full force and effect upon execution by the respective parties in counterpart.
In the event either party breaches this Agreement, the costs and attorney fees
incurred by the non-breaching party associated with enforcement or collection activity pertaining
to this Agreement shall be paid by the party breaching this Agreement to the non-breaching party.
f 55 E t New England Avenue
/Winter Park, Florida 32789
Dated: G ( ·i S\
Dated: b/ 2"=>
, 2009
2009
Title
2727 Mahan Drive, Mail Stop #3
Tallahassee, 3
{If - Dated: g/6 ,2009 Peter Williams
Inspect al
Dated: 8/s , 2009 Justin enior 7
General Counsel
C:
/Yv:_,
<z "'-- Dated: t le3t , 2009
di de
Kim ellum l
Chief Medicaid Counse
I Dated: q
Kell
Assistant General Counsel
,\ I , 2009
| Issue Date | Document | Summary |
|---|---|---|
| Aug. 10, 2009 | Agency Final Order |
