Fa RRGR OT mereniEtieEs Ge STATE OF FLORIDA ; AGENCY FOR HEALTH CARE ADMINISTRATION DOCTORS MEDICAL CENTER, FSR-ClWS Petitioner, vs. DOAH CASE NO. 00-4202 Audit No. AGENCY FOR HEALTH CARE ADMINISTRATION, Respondent. / FINAL ORDER | THE PARTIES resolved all disputed issues and executed a settlement agreement 2 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 i is CLOSED. DONE AND ORDERED on this the A a Keay of Mogul / , 2001, in ‘ Tallahassee, Florida. alfnel Medows, He, Secretary . Agency for Health Care Administration a Sere an Sk RS RN RRS Sa .~ Finance & Accounting — semamaa riers enced sama nersense nee OTe 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 AGEN CY 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: Gary J. Clarke Sternstein, Rainer & Clarke, PA 101 North Gadsden Street Tallahassee, Florida 32301 Anthony Conticello Agency for Health Care Administration 2727 Mahan Drive, Mail Stop #3 Tallahassee, Florida 32308-5403 Florence S. Rivas Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway “Tallahassee, Florida 32399-3060 Charlie Ginn, Chief Medicaid Program Integrity Agency for Health Care Administration 2727 Mahan Drive, Mail Stop #6 ‘Tallahassee, Florida 32308 | | \ : f ee ee ae Sth yt eR ~v CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the foregoing Fina! Order has been furnished to the above-named persons or entities by U.S. Mail, or by, inter-office mail for AHCA personnel and entities, on the //— day of , 2001. Diane A. orn Agency Clerk Agency for Health Care Administration 2727 Mahan Drive, Suite 3431 Fort Knox Building III, MS 3 Tallahassee, Florida 32308 850/922-5865 cept rere eee ie dediediiaiehe adc diet a ore rer iba we HEY Se compliance with Chapter 409, Florida Statutes, and the Medicaid Provider Handbook. oo wer ° Agency Audit of Medics . amount of. $364, 5331 28 for the period uly 1, 1996 5 through July 8, 8, 1998. In Tesponse, STATE OF FLORIDA DIVISION OF ADMINISTRATIVE HEARINGS vcomomencm, SBN Petitioner, JN 1 2001 vs. Case No. 00-4202 AHCA General Counsel's Office AGENCY FOR HEALTH CARE ADMINISTRATION, Respondent. ; / SETTLEMENT AGREEMENT STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION ("AHCA" or "the Agency"), and DOCTORS MEDICAL CENTER, ("PROVIDER"), by and through the undersigned, hereby stipulate and agree as follows: 1. _ This Agreement is entered into between the parties to resolve issues of Petitioner's i 2. PROVIDER i is a Medicaid provider in the State of Florida. 3. By letter dated A ugust 8, 2000, AHCA notified the PROVIDER that a Final PROVIDER requested a formal administration hearing, ; ‘. lessons aie / “in order to resolve this matter without the e burden, “uncertainty and expense of expressly agree as follows litigation, the PRC “AHCA grees. to accept the payment set forth he i a) "settlement of the overpayment is issues ‘uncovered by the above-referenced 7 Page 1 of 6 i My ip mrerr I e rRRe {oo BiB ERR RRB TS b.) c.) d.) e.) . "Payment, usURURO MARIN Ga audit, and agrees not to impose any fines or penalties arising from Medicaid billings for the period July 1, 1996 through July 8, 1998. AHCA agrees not to terminate the PROVIDER from the Medicaid program for the overpayments uncovered by the audit so long as PROVIDER complies with this Agreement, and continues to comply with Florida Statutes, rules, regulations and policies pertaining to the Medicaid program. | This Agreement concludes the Audit Investi gation (C.I. 98-0931-000). PROVIDER agrees to pay the Agency one hundred sixty thousand dollars ($160,000.00) plus ten percent interest, in thirty monthly installments of $6,049.83, with the first payment due 30 days after the execution of this settlement agreement and continuing monthly until payment is made in full. An amortization schedule is attached hereto and incorporated herein by. refere! nce. At any time daring the payment terms set forth above, PROVIDER ‘may Tepay the entire remaining principal due in a lump sum payment, without penalty for the scheduled interest that is due subsequent to the lump sum 5. Payments made pursuant to this Agreement shall be made to: ~ “AGENCY FOR HEALTH CARE ADMINISTRATION Medicai | Accoun Receivable _ “Post Office Box 13749 i Tallahassee, Florida 31317-3749 6. Upon. receipt o of full payment to the Agency of the a amount provided in paragraph “four (4), the Agency hereby ag agrees to release the Provider from any and all liability arising from Page 2 of 6 et eae a dl : sigue due z and owing to PROVIDER for any Medicaid claims, (CLL No. 98- 0931- 800) as ‘set forth i in the Agency’ s “final a audit letter dated sd August & 8, 2000, incorporated herein by reference. 7. In the event that PROVIDER fails to make any payment due hereunder, the Agency may, with twenty (20) days notice to PROVIDER, deem PROVIDER in default. If notice is given and PROVIDER fails to remit the outstanding payment or payments to AHCA in full within twenty (20) days after receipt of the notice, PROVIDER shall be in default. Once PROVIDER is in default, the full outstanding balance specified in paragraph 4 (d) shall be due and payable. In such event, PROVIDER’S participation in the Medicaid program shall be suspended until such time as the Agency receives payment of the balance in full. Nothing in this paragraph shall be construed to limit in any way the ability of the AGENCY to terminate PROVIDER pursuant to Section 409.907(2), F.S. (1999). Notwithstanding the foregoing, the AGENCY agrees not to terminate PROVIDER based on findings in the instant audit so long | a PROVIDER complies with this Agreement. However, if PROVIDER fails to cure its default hereunder within twenty (20) days of written notice, PROVIDER understands and agrees that tthe | Agency n may exercise its option to terminate PROVIDER from the Medicaid program. 8. PROVIDER. agrees that failure to pay any monies ‘due and 9. _ AHCA Teserves the right to enforce this s Apeement under the Jaws of the > State of : _ io ll. The signatories to this agreement acknowledge th that at they are duly authorized to Page 3 of 6 (etotedaneiicantiaeaiiae SRE me eer ieee Ae enter into this Agreement on behalf of the respective parties. 12. 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. 13. 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 attorney's fees and costs, shall be paid by the breaching party to the nonbreaching party. 14. This Agreement constitutes the entire agreement between PROVIDER and 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. 15. This is an Agreement of settlement and compromise, made in n recognition that the ; parties may have different or incorrect understandings, information and contentions, as to > facts ee ee ee and I law, and with each party compromising and setting any potential correctness or ¥E a incorrectness of i its understandings, information and contentions as to 0 facts and jaw, so that no 1a I be a ground for rescission hereof, abe MRR SNE 16. PROVIDER expressly waives in this matter its right to any hearing Pursuant to Sections 120. 569 or 120. 57, Florida Statutes, the we making c or * findings o of fact and conclusions of Medicaid billing oa the period of ly 1, 1996 trough J July 8, 1998 C1 Ld 498, 0931. 000), PROVIDER further agrees that. it shall not challenge or contest any Fi inal Order entered i inthis Page 4 of 6 a matter 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, except to enforce the obligations of the AGENCY under this Agreement. 17. 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 ori ginating or preparing it. 18. To the extent that any provision of this Agreement is prohibited by law for any reason, the offending portions of the provision shall be deemed separated, and the other portions of the provision shall remain effective to the extent not so prohibited. The remaining portions of this Agreement shall remain in full force and effect, without affect from the offending provision. 19. This Agreement shall inure to the benefit of and be binding on each party's successors, assigns, heirs, administrators, tepresentatives and trustees, 20. _ All times stated herein are the essence of this Agreement. 21. This Agreement shall be in full force and effect upon execution by the respective parties in counterpart. 2. _NoTIcE - - Unless changed in writing, notice shall only be effective by U.S. Mail, certifi ed return receipt, to the partes respective addresses specifi ed below: FLORIDA AGENCY F OR HEALTH CARE DOCTOR'S MEDICAL CENTER ADMINISTRATION 1240 Northwest 119th Street 2727 Mahan Drive, Ft. Knox Bldg. #3 - Miami, Florida 33167 Tallahassee FL 32308-: 5403 ss cha gannttasosPoeusesSatnacibtn poate Page 5 of 6 er ee RR EE BES leg ihe DOCTORS MEDICAL CENTER 1240 Northwest 119th Street Miami, Florida 331 Dated: w/sifer -, 2001 BY: Venbyrd y fh oy rs: Pyes,dout FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION 2727 Mahan Drive, Ft. Knox Bldg. #3 Tallahassee, FL 32308-5403 Wile DATED: C fete , 2001. RUFUSNOBLE INSPECTOR GENERAL CHIEF OF MEDICAID PROGRAM INTEGRITY ANTHONY L. CONTICELLO ASSISTANT GENERAL COUNSEL Page 6 of 6 ~ DATED: (24 1) / , 2001. a ee =) Doctor's Medical Center/Provider # 0636673-00/C. |. # 98-0931-000 LOAN DATA Past Due Balance:|$160,000.00 Annual int rate:|10.00% Term in years:|2.5 Payments per year:/12 First payment due:|08/01/2001 CALCULATED PAYMENT Entered payment: Calculated payment: AMOUNT USED Monthly Pmt Used: ist Pmt in Table: Table $6,049.83 SSE SS AGENCY FOR HEALTH CARE ADMINISTRATION AMORTIZATION SCHEDULE Table starts at date: or payment number: 14 $160,000.00 Cumulative interest prior to payment 1: $0.00 Payment Beginning Ending Cumulative | Payment Date a Due Date Balance Interest p Balance Interest Amount Paid 1 08/01/2001 160,000.00 1,333.33 4,716.50 155,283.50 1,333.33 | 6,049.83 _| | SY 09/01/2001 155,283.50 1,294.03 4,755.80 150,527.70 2,627.36 | 6,049.83 [SY 3_ | 10/01/2001 150,527.70 1,254.40 4,795.43 145,732.27 3,881.76 | 604983 [i 4 | 11/01/2001 145,732.27 1,214.44 4,835.39 140,896.88 5,096.20 | 604983 [is | 5 | 12/01/2001 140,896.88 1,174.14 4,875.69 136,021.19 6,270.34 | 604983 [i+ me | 6 | 01/01/2002 136,021.19 1,133.51 4,916.32 131,104.87 7,403.85 | 604983 [ i 7 | 02/01/2002 131,104.87 1,092.54 4,957.29 126,147.58 8,496.39 [| 604983 [id ' 8 | 03/01/2002 126,147.58 1,051.23 4,998.60 121,148.98 9,547.62 | 604983 [Cd ' 9 | 04/01/2002 121,148.98 1,009.57 5,040.26 116,108.72 10,557.19 [604983 [| ‘ 10 | 05/01/2002 116,108.72 967.57 5,082.26 111,026.46 11,524.76 | 6,049.83 [oY ; 11 | 06/01/2002 111,026.46 925.22 5,124.61 105,901.85 12,449.98 | 604983 [| . 12 | 07/01/2002 105,901.85 882.52 5,167.31 100,734.54 13,332.50 | 604983 [ 13 | 08/01/2002 100,734.54 839.45 5,210.38 95,524.16 14,171.95 | 6.04983 [CS 14 | 09/01/2002 95,524.16 796,03 5,253.80 90,270.37 14,967.99 | 604983 [sd ek 15 {| 10/01/2002 90,270.37 752.25 5,297.58 84,972.79 15,720.24 604983 [| 16 | 11/01/2002 84,972.79 708.11 5,341.72 79,631.07 16,428.35 | 6049.63 [ST an 17 | 12/01/2002 79,631.07 663.59 5,386.24 74,244.83 17,091.94 | 6.04983 [+4 ef 18 | 01/01/2003 74,244.83 618.71 5,431.12 68,813.71 17,710.65 | 604983 [st 7 19 | 02/01/2003 68,813.71 573.45 5,476.38 63,337.33 18,284.10 [ 604983 [ : 20 | 03/01/2003 63,337.33 527.81 5,522.02 57,815.34 18,811.94 | 6,049.83 [SY ral 21 [| 04/01/2003 57,815.31 481.79 5,568.04 52,247.27 19,293.70 | 6,049.83 [SY “ 22 {| 05/01/2003 52,247.27 435.39 5,614.44 46,632.83 19,729.09 | 604983 [Ss me 23 | 06/01/2003 46,632.83 383.61 5,661.22 40,971.61 20,117.70 | 6049.83" [SY S : 24 | 07/01/2003 40,971.61 341.43 5,708.40 |] 35,263.21 20,459.13 | 604983 [CY we Page 1 of 1 TET RR RR RT ERR AGENCY FOR HEALTH CARE ADMINISTRATION AMORTIZATION SCHEDULE Doctor's Medical Center/Provider # 0636673-00/C. I. # 98-0931-000 $35,263.21 Table Starts at date: 10.00% or payment number: 4 Past Due Balance: Annual int rate: Term in years: Payments per year: First payment due:/08/01/2003 CALCULATED PAYMENT Entered payment: Calculated payment: AMOUNT USED Monthly Pmt Used: ist Pmt in Table: $1,333.35 $35,263.21 $6,049.83 1 Cumulative interest prior to payment 1: $20,459.13 Table Payment Beginning Ending Cumulative | Payment Date Due Date Balance Interest p Balance Interest Amount Paid. 1 08/01/2003 35,263.21 5,755.97 29,507.24 20,752.99 | 6,049.83 _ | | Cis@Y 09/01/2003 29,507.24 5,803.94 23,703.30 20,998.88 | 604983 [+ 3 10/01/2003 23,703.30 5,852.30 17,851.00 21,196.44 [604983 [Sd 4 11/01/2003 17,851.00 5,901.07 11,949.93 21,345.17 [ 6,049.83 [ +d 5 12/01/2003 11,949.93 5,950.25 5,999.68 21,444.75 | 6,049.83 [ ——_—~«d| 6 | 01/01/2004 5,999.68 5,999.68 0.00 21,494.75 | 604968 [| 7 02/01/2004 0.00 0.00 0.00 0.00 — | 0.00 [SS 8 | 03/01/2004 0.00 0.00 0.00 0.00 | 0007 [sd 9 04/01/2004 0.00 0.00 0.00 0.00 | 000 J 10 | 05/01/2004 0.00 0.00 0.00 0.00 [000 TS 11 | 06/01/2004 0.00 0.00 0.00 0.00 | 0.00 SC~S~*S 12 | 07/01/2004 0.00 0.00 0.00 0.00 | 0007 {+4 13 | 08/01/2004 | 0.00 0.00 0.00 0.00 | 0.00 14 | 09/01/2004 0.00 0.00 0.00 0.00 [000 [SC 15 | 10/01/2004 0.00 0.00 0.00 0.00 es 16 | 11/01/2004 0.00 0.00 0.00 0.00 | 000 TCS 17 | 12/01/2004 0.00 0.00 0.00 0.00 | 0.00 [1 18 | 01/01/2005 0.00 0.00 0,00 0.00 | 0.007 | S—S 19 | 02/01/2005 0.00 0.00 0.00 0.00 | 0.00 sd : 20 | 03/01/2005 0.00 0.00 0.00 0.00 | 0.007 [SS 21 | 04/01/2005 0.00 0.00 0.00 0.00 [000 TOSS 22 | 05/01/2005 0.00 0.00 0.00 0.00 | 0007 [| 23 | 06/01/2005 0.00 0.00 0.00 0.00 | 0007 [SCS 24 | 07/01/2005 0.00 [0007 | SY 0.00 Page 1 of 1 > RAINER& CLARKE ATTORNEYS. BRN counszzors a lit Pee ee Tune 1, 2001 CaIV ED) gum 2 2001 AHCA @onerai Gourset's Cffice Anthony Conticello, Esq. . ‘Pe Office of the General Counsel Agency for Health Care Administration 2727 Mahan Drive Tallahassee, FL 32308 Re: Settlement Agreement — Doctors Medical Center f= DOAH Case No: 00-4202 Dear Teoma Enclosed, please find the original copy of the Settlement Agreement you sent to me. It is signed by Ventura DePaz, President of Doctors Medical Center, Medicaid Provider No.. 0636673-00. I would appreciate it if you could send me a copy of this document once it is signed and dated by all of the required signatories at your Agency. * Thank you for your time, cooperation, and courtesy in settling this matter. Please call me if there are any questions. Sincerely, TEIN, RAINER & CLARKE Enclosure: 6 pp. cc: Ventura DePaz 101 NORTH GADSDEN ST.* TALLAHASSEE, FLORIDA 32301 « 850.577.6557 TEL * 850.577.6599 FAX

Docket for Case No: 00-004202