Aug 21 2009 14:24 AUG-21-2089 15:36 AGENCY HEALTH CARE ADMIN 856 921 4158 P.28 sooB (9056 ON Xa/XL) LP'eT NHL 600e/sc/90 Matt G07 Y FILED ; STATE OF FLORIDA AHCA AGENCY FOR HEALTH CARE ADMINISTRATION AGENCY CLERK STATE OF FLORIDA, MR JUN 11 Pl 23 AGENCY FOR HEALTH CARE ADMINISTRATION, Petitioner, vs. Audit No.: C1 07-4618-000 Provider No.: 3757269-00 SERGIO J. JACINTO, M.D. Respondent. : / FINAL ORDER THIS CAUSE’ is before me for issuance of a Final Order. In a letter dated December 9, 2008, Scrgio J. Jacinto, M.D. (Respondent) was informed that the State of Florida, Agency for Health Care Administration (Agency) was secking to recoup Medicaid overpayments in the amount of $71,429.83. Additionally, the Respondent was notified that the Agency imposed a fine in the amount of $2,000.00 and required the submission of a corrective action plan in ‘the form of an Acknowledgement Statement, pursuant to Rule 59G-9.070, Florida Administrative Code. Pursuant to Section 409,913(6), Florida Statutes, the letter was sent to Respondent at the address lust shown on the provider corollment file. The letter was delivered 10 Respondent on December 12, 2008. The letter contained full disclosure and notice regarding Respondent’s administrative _ hearing and due process rights. To date, Respondent has not requesied a hearing to dispute the facts contained in the letter. Jonevcnnca f¥uo NOW Qa~uIaer oOTbsaec per:iqn enne/sesan Aug 21 2009 14:24 AUG-21-2089 15:36 AGENCY HEALTH CARE ADMIN 856 921 4158 P.2i p00R [9086 ON KW/XL] 4¢:€T AHL 6007/52/90 EINDINGS OF FACTS 1. The Respondent received a final audit report (letter) on December 12, 2008 that identified an overpayment amount owed to the Agency in the amount of $71,429.83. Additionally, the Provider was notified that the Agency imposed a fine in the amount of $2,000.00 and required the submission of a corrective action plan in the form of an Acknowledgement Statement. 2. The letter disclosed the Respondent's administrative and due process rights. 3. The Respondent has noi disputed the facts set forth in the letter. Therefore, those facts, each and every one, arc hereby desmed admimed, and form the factual basis for the existence of an overpayment owed by Respondent. That amount is now due and owing, with interesl, as mote fully set forth below, 4. Additionally, since the Respondent has not disputed the facts set forth in the letter, the sanction as described in the aforementiondd letter is now due to the Agency. CONCLUSIONS OF LAW >, The Agency incorporated and adopts the statements and conclusions of law as set forth in the aforementioned letter. 6. The admitted facts support the conclusion that the amouzt of the stated overpayment and the sanction(s) imposed are due and owing, under the law generally set forth in the letter. 7. Furthermore, Respondent is advised that pursuant to Section 409.913 Florida Statutes, failure ta pay in full, or enter into and abide by the terms of any repayment schedule set forth by the Agency may result in termination from the Medicaid program, withholding of future Medicaid payments, or other such remedies as provided by law. @ 13aq7ann‘d fvH4) OW GQ4uUlaeP ofbuag go:if 6002/52/90 Aug 21 2009 14:24 AUIG-21-2889 15:37 AGENCY HEALTH CARE ADMIN 856 921 4158 P22 £UUl) LUO UN AZ AL 4P-bl UML DUUG/ Sé/BU 8. Finally, Respondent is advised that continued noncompliance, including the fuilure to satisfy the terms of the sanction imposed, may result in additional sanctions pursuant 19 Rule 59G-9.070, Florida Administrative Cade. ORDER BASED on the foregoing, it is ORDERED and ADJUDGED that Respondent refund, forthwith, the sum of $73,429.83, together with such statulory interest as is set forth in Section 409.913(25)(c), Florida Statutes. This amount due will be offset by any amount alreaily reccived by the Agency in this matter. Lo cf ; . DONE AND ORDERED this _| © dayof Ore, 2004 _, in Tallahassee, Florida. fo tt de Holly Benson, Secretary Agency for Health Care Administration y3an/Inn'd fyud ny OFuUtpbpr oOotbBsgac oc:in eEnnaesctsvan Aug 21 2009 14:24 AUG-21-2089 15:37 AGENCY HEALTH CARE ADMIN 856 921 4158 P.23 800R) [9086 ON YA/XLI Lb eT NHL 6007/52/90 CERTIFICATE OF SERVICE 1 HEREBY CERTIFY that 2 true and correct copy of the foregoing has been served on the above-named persons by U.S. Mail or interoffice mail as indicated on this the [Pay of ene 200" Richard Shoop, Agency Clerk State of Florida Agency for Health Care Administration 2727 Mahan Drive, Building #3 Tallahassee, Florida 32308-5403 (850) 922-5873 6) 1an/oqon ‘4 f¥H4) NW ozuts.er otBuac Aasild gsone/sse/90

Docket for Case No: 09-004615MPI

Orders for Case No: 09-004615MPI