Hatha. . a : ; STATE OF FLORIDA DIVISION OF ADMINISTRATIVE HEARINGS HALIFAX MEDICAL CENTER, Petitioner, vs. = Audit CI No. 97-1306-075 ie STATE OF FLORIDA, Rendition No. AHCA-01-222-S-MDO AGENCY FOR HEALTH CARE ADMINISTRATION, ”) RA Cu) SS Respondent. / FINAL ORDER THE PARTIES resolved all disputed issues and executed a Settlement Agreement on Anyus {OQ __, 2001, which is 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 Lothaes ot /lugulT, 2001, in Tallahassee, Florida. hj i" Rhonda4. Medows, MD, FAAFP, Secretary Agency for Health Care Administration i eee ning ep ee A PARTY WHO IS ADVERSELY AFFECTED BY THIS FINAL ORDER IS ENTITLED TO A JUDICIAL REVIEW WHICH SHALL BE INSTITUTED BY FILING ONE COPY OF A NOTICE OF APPEAL WITH THE AGENCY CLERK OF AHCA, AND A SECOND COPY ALONG WITH FILING FEE AS PRESCRIBED BY LAW, WITH THE DISTRICT COURT OF APPEAL IN THE APPELLATE DISTRICT WHERE THE AGENCY MAINTAINS ITS HEADQUARTERS OR WHERE A PARTY RESIDES. REVIEW PROCEEDINGS SHALL BE CONDUCTED IN ACCORDANCE WITH THE FLORIDA APPELLATE RULES. THE NOTICE OF APPEAL MUST BE FILED WITHIN 30 DAYS OF RENDITION OF THE ORDER TO BE REVIEWED. Copies furnished to: L. William Porter II, Esquire Agency for Health Care Administration (Interoffice Mail) Donald R. Alexander The Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-30060 David J. Davidson, Esquire General Counsel Halifax Community Health System Post Office Box 2830 Daytona Beach, Florida 32120-2830 Charlie Ginn, Chief, Medicaid Program Integrity Mike Morton, Program Administrator, Medicaid Program Integrity Willie Bivens, Finance and Accounting CERTIFICATE OF SERVICE LERTIPILAIGC VEE ee I HEREBY CERTIFY that a trué and correct copy of the foregoing Final Order has been furnished tg the above-named persons or entities, by U.S. Mail or inter-office mail, on this [4 = day of Daptiunber 1 2001. Diane A. Grubbs, Agency Clerk Agency for Health Care Administration 2727 Mahan Drive, Suite 3431 Fort Knox Building III, MS 3 Tallahassee, Florida 32308 850/922-5865 HALIFAX MEDICAL CENTER DOAH No. 99-2183 Provider No. 010184200 . C.I. No. 97-1306-075 SETTLEMENT AGREEMENT STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION (‘AHCA’ or “the Agency”), and Halifax Medical Center (“PROVIDER”), by and through the undersigned, hereby stipulate and agree as follows: 1. This Agreement is entered into between the parties for the purpose of avoiding the costs and burdens of litigation, and neither party concedes the others position. 2. PROVIDER is a Medicaid provider in the State of Florida. 3. In its final agency audit report dated April 7, 1999, 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. The Agency sought overpayment in the amount of $28,097.28. In response to the audit letter dated April 7, 1999, PROVIDER filed a petition for a formal administrative hearing which was assigned DOAH Case No. 99-2183. 4. In order to resolve this matter without further administrative proceedings, PROVIDER and the AHCA expressly agree as follows: (1) | AHCA agrees to accept the payment set forth herein in settlement of the overpayment issues arising from the MPI review. peer eee een ope (2) Within thirty days of receipt of the final order, PROVIDER agrees to pay the Agency the sum of fourteen thousand forty-eight dollars ($14,048.00) to be made in one lump sum in full and complete settlement of all claims in the proceedings before the Division of Administrative Hearings (DOAH Case No. 99-2183). (3) 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.1. 97-1306-075. (4) PROVIDER agrees that it will not rebill the Medicaid Program in any manner for claims that were not covered by Medicaid, which are the subject of the audit in this case. 5. Payment shall be made to: AGENCY FOR HEALTHCARE ADMINISTRATION Medicaid Accounts Receivable Post Office Box 13749 Tallahassee, Florida 32317-3749 6. 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. 7. 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. omen mes we copra 8. This settlement does not constitute an admission of wrongdoing or error by either party with respect to this case or any other matter. However, the parties believe that this matter should be settled because the parties have agreed to the terms contained within this agreement. 9. Each party shall bear its own attorneys’ fees and costs, if any. 10. 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. . 41. | 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. 12. In the event that a party breaches this Agreement, and enforcement of this Agreement or recovery of damages for breach hereof is obtained by law or by legal proceedings through an attorney at law, all costs of collection or enforcement, including reasonable attorneys’ fees, shall be paid by the breaching party to the non-breaching party. . 13. 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. 14. 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. 15. 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. 16. 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. 17. 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.. 18. | This Agreement shall inure to the benefit of and be binding on each party’s successors, assigns, heirs, administrators, representatives and trustees. 19. All times stated herein are of the essence of this Agreement. 1b ee ar RF oe 20. This Agreement shall be in full force and effect upon execution by the respective parties in counterpart. Dated: Joly 30 , 2001 (Print name) ITS: Geueral G vnsel FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION ; 2727 Mahan Drive, Mail Stop #3 Tallahassee, FL 32308-5403 Dated: B// , 2001 Rufus Noble inspector General Dated: 6) | , 2001 “Wited: S- G G , 2001 L. William Porter II Assistant General Counsel es cose ster rene tee coe ee oe ee DAVID J. DAVIDSON GENERAL COUNSEL HALIFAX aan COMMUNITY HEALTH SYSTEM April 22, 1999 APR 29 1999 Edward W. Turner, Chief Medicaid Program Integrity MEDICAID PROGRAN State Health Purchasing INTEGRITY. M Agency for Health Care Administration 2727 Mahan Drive Tallahassee, FL 32308-5403 Re: Final Agency Audit Report ~ Corrected CI 97-1306-075 Provider No. 010184200 Dear Mr. Turner: ~ This letter shall serve as Halifax Medical Center’s request for an informal hearing pursuant to . Florida Statutes §120.57 in regards to the determination that we were overpaid in regards to certain services rendered to patients Dominique J. Barton ($780.48); Dale A. Quatto, Jr. . -. ($6,243. 84); Alfred W. Heindl, Ir. ($5,463.36); Michael J. Toby ($5,463.36); Bianca R. Hull * ($780.48); Joshua D. Vigeant ($3,902.40); Brandy L. Larkowski ($1,560.96); Nicholas B. Ardella ($1, 560.96); and Mari E. King ($780.48). ‘It is our position that these services were indeed properly reimbursed, ‘and the $26,536.32 allegedly overpaid for these services was in fact properly paid. Please consider this our request for an informal hearing. vee Thank you for your cooperation. ~~ General punsel Associates in Medicine »Clyatt's Quality Care Florida Health Care Plans «Halifax Home Health + Halifax Mecca Center - HMC Foundation « Healthy Families * Hospice of Volusia/Flagier « Volusia Health Network 303 N. Clyde Morris Boulevard * Post Office Box 2830 + Daytona Beach, Florida 32120-2830 « (904) 254- 4000

Docket for Case No: 99-002183