PILED STATE OF FLORIDA CFP IT OI DIVISION OF ADMINISTRATIVE HEARINGS e AHGA PART SPICLERK a r rem ~ OB/GYN SPECIALISTS OF THE PALM BEACHES, INC., BE: ot oe, 7 S fi co) Petitioner, eS vs. DOAH CASE No.: 00-2972 PROVIDER NO. 372700900 AUDIT NO. C.I. 99-0824-000 AGENCY FOR HEALTH CARE RENDITION NO.: AHCA-01-237-S-MDO ADMINISTRATION, Respondent. __/ FINAL ORDER THE PARTIES resolved all disputed issues and executed a Settlement Agreement on August 27 , 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 rth. day of Haga, 2001, in Tallahassee, Florida. Rhofida 4 Medows, MD, Secretary Agency for Health Care Administration 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) Claude Arrington The Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-30060 J. Stephen Menton, Esquire Rutledge, Ecenia, Purnell & Hoffman, P.A. Post Office Box 551 Tallahassee, Florida 32302 Charlie Ginn, Chief, Medicaid Program Integrity Phyllis Stiver, Medicaid Program Integrity Willie Bivens, Finance and Accounting CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the foregoing has been furnished to the above named addressees by U.S. Mail on this the LE, ot ep lbentter 2001. Agency Clerk State of Florida Agency for Health Care Administration 2727 Mahan Drive, Building #3 Tallahassee, Florida 32308-5403 (850) 922-5865 OB/GYN SPECIALISTS OF THE PALM BEACHES, INC. DOAH No. 00-2972 Provider No. 372700900 C.1. No. 99-0824-000 SETTLEMENT AGREEMENT STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION ("AHCA” or “the Agency”), and OB/GYN Specialists of the Palm Beaches, Inc. (“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 other's position. 2. PROVIDER is a Medicaid provider in the State of Florida. 3. In its final agency audit report dated April 24, 2000, 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 $63,279.26. In response to the audit letter dated April 24, 2000, PROVIDER filed a petition for a formal administrative hearing which was assigned DOAH Case No. 00-2972. 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. & an (2) (3) (4) (5) PRR Within thirty days of receipt of the final order, PROVIDER agrees to make-the-firet-installment=te repay twenty thousand four hundred sixty-two dollars and fifty-three cents ($20,462.53) to be made in wloniy ur Oh eT monthiypayments in full and complete settlement of all claims in the proceedings before the Division of Administrative Hearings (DOAH Case No. 00-2482). 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. 99-0824-000. 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. AHCA agrees that this matter did not constitute fraud and abuse of the Medicaid program, and was a matter of inadvertence on the part of the PROVIDER. AHCA agrees to make this known to any agency or entity, not limited to Boards or professional regulation entities. Payment shall be made to: AGENCY FOR HEALTHCARE ADMINISTRATION Medicaid Accounts Receivable Post Office Box 13749 ~ Tallahassee, Florida 32317-3749 et al Tone reenter Sense fs UA IN a eS te tegen eee nfl 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. 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. 11. This Agreement shall be construed in accordance with the provisions of Bes Esc Sakae sg ies the laws of Florida. Venue for any action arising from this Agreement shall be j in Leon lamages for breach hereof is obtained by law or by legal proceedings through : an "attorney at law, ail costs of collection or enforcement, _ including reasonable attorneys’ fees, shall be paid by the breaching party to the 1 non- breaching party. Sore np nme wee ener ope 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 ae settlement agreement i in any y forum n now or in the future available to it, including the right to any admini trative Proceeding, circuit or federal court action or any appeal. Te ee em vere: Coie yi ee al 5 ‘Tallahassee, | FL - 32308-5403 Rie Lefapltte "a an a EE A et Smee sera 16. This is Agreement i 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. 20. ‘This Agreement shall be in full force and effect upon execution by the respective parties in counterpart. OB/GYN SPECIALISTS OF THE PALM BEACHES, INC. Si, Dated: Suy Sl , 2001 BYY JouN A. Brbico, Hp (Print name) ITS: Vice Bes ENT FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION 2727 Mahan Drive, Mail Stop #3 _ Dated: bf® 7 , 2001 Inspector General { | f ‘ ' RE TT RO re Re 2 ) e | tulle Dated: fey , 2001 yy ) Dated: Bi¥- AF 2001 General Cotinsel Assistant General Counsel er eremiricts ert -! AGENLY FOR HEALTH CARE ADMINISTRATION AMORTIZATION SCHEDULE OB/GYN Specialists of the Palm Beaches/Provider # 3727009-00/ C. 1. # 99-0824-000 $20,462.53 Table starts at date: 10.00% or payment number: 1 2 : Past Due Balance: Annual int rate: Term in years: Payments per year:|12 First payment due:/09/15/2001 CALCULATED PAYMENT ; $20,462.53 _ Cumulative interest prior to payment 1: $0.00 Table ; Payment Beginning Ending Cumulative {| Payment Due Date Balance Principal Balance Interest Amount 1 Interest 09/15/2001 20,462.53 773.73 19,688.80 170.52 2 | 10/15/2001 19,688.80 780.18 18,908.62 334.59 3} 11/15/2001 18,908.62 786.68 18,121.95 492.17 4 | 12/15/2001 18,121.95 793.23 17,328.71 643.18 5 | 01/15/2002 17,328.71 799.84 16,528.87 787.59 6 | 02/15/2002 16,528.87 806.51 15,722.36 925.33 7 { 03/15/2002 15,722.36 813.23 14,909.13 1,056.35 8 | 04/15/2002 14,909.13 820.01 14,089.12 1,180.59 9 | 05/15/2002 14,089.12 826.84 13,262.28 1,298.00 10 | 06/15/2002 13,262.28 833.73 12,428.55 1,408.52 [944.25 | 11 | 07/15/2002 12,428.55 840.68 11,587.87 1,512.09 12 | 08/15/2002 11,587.87 847.68 10,740.19 1,608.66 13 | 09/15/2002 10,740.19 854.75 9,885.44 1,698.16 14 | 10/15/2002 9,885.44 861.87 9,023.57 1,780.54 | 94425 | 15 | 11/15/2002 9,023.57 869.05 | 8,154.54 1,855.73 | 94425 | 16 | 12/15/2002 8,154.51 "876.30 7,278.22 1,923.69 17 | 01/15/2003 7,278.22 883.60 6,394.62 1,984.34 18 | 02/15/2003 6,394.62 890.96 5,503.66 2,037.63 19 | 03/15/2003 5,503.66 898.39 4,605.27 2,083.49 20 | 04/15/2003 4,605.27 905.87 3,699.40 2,121.87 [944.25 | 05/15/2003 3,699.40 913.42 2,785.98 2,152.70 06/15/2003 2,785.98 921.03 1,864.94 2,175.91 [944.25 | 07/15/2003 1,864.94 928.71 936.23 2,191.45 936.23 0.00 2,199.26 | 944.04 | 4 | 08/15/2003 936.23 Page 1 of 4

Docket for Case No: 00-002972