036° one STATE OF FLORIDA SSEP30 PN 2: 4a DIVISION OF ADMINISTRATIVE HEARINGS r VINCENTIN. JARVIS, M.D., Petitioner, 7 L-closecl vs. CASE NO. 00-5074 Audit No.: CI 97-1070-000 STATE OF FLORIDA, Provider No.. AGENCY FOR HEALTH CARE : ADMINISTRATION, RENDITION NO.: AHCA-03-0619-S-MDO Respondent. / FINAL ORDER THIS CAUSE is before me for issuance of a Final Order. In a letter dated August 24, 2000, Vincent N. Jarvis, M.D. (Petitioner) was informed that the State of Florida, Agency for Health Care Administration (Agency) was seeking to recoup Medicaid overpayments in the amount of $1,881,737.71. The Petitioner requested and was granted a formal administrative hearing. Petitioner filed voluntary Chapter 7 bankruptcy on February 4, 2002. The Medicaid overpayment of $1,881,737.71 was all pre-petition and discharged in bankruptcy by Judge Robert E. Gerber who issued a Discharge of Debtor Order of Final Decree on June 26, 2003. 2K Based on the foregoing, the overpayment amount of $1,881,737.71 has been discharged in bankruptcy and no money is due and owing to the Agency by Petitioner. The request for a hearing is dismissed and the file is CLOSED. DONE and ORDERED on Leplrnber 11, 2003, in Tallahassee, Florida. 4, Rhonda Medows, MD, Secretary Agency fer 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 Assistant General Counsel Agency for Health Care Administration (Interoffice Mail) Ian J. Gazes, Esquire Gazes & Associates, LLP Attorneys for the Chapter 7 Trustee Of the Estate of Vincent N. Jarvis 1675 Broadway, 26t Floor New York, NY 10019 (U.S. Mail) John G. Van Laningham Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 Tim Byrnes, Chief, Medicaid Program Integrity Pam Langford, Medicaid Program Integrity John Hoover, Finance & 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 Sept OF , 2003. SAR. Gonzales .(@ Lealand McCharen, Esquir: Te Agency Clerk State of Florida Agency for Health Care Administration 2727 Mahan Drive, Building #3 Tallahassee, Florida 32308-5403 (850) 922-5873 SIALE UF FLORIDA HCA AGENCY FOR HEALTH CARE ADMINISTRATION wers 3 r a oo NEC 15 PHS 19 JEB BUSH, GOVERNOR AUBEN J. KINdIgYa 4 18 : ave August 24, 2000 reer ir CERTIFIED MAIL - RETURN RECEIPT No. 7000 0600 0027 1522 7935 \ U Provider No. \ AL, Vv OO-507Y Gs Je" Vincent N. Jarvis, M.D. » \\ 1680 Michigan Ave. #820 A® NN Miami Beach, Florida 33139 a In Reply Refer to FINAL AGENCY AUDIT REPORT C.I. 97-1070-000/WG2/ART Dear Provider: The Agency for Health Care Administration, Medicaid Program Integrity office has completed the review of your Medicaid claims for the procedures specified below for dates of service January 1, 1996 through April 21, 1999. A physician consultant with a specialty in infectious diseases reviewed your medical records. A Preliminary Agency Audit Report dated May 12, 1999, was sent to you indicating that you were overpaid $1,881,737.71. A subsequent telephone conference including you and your attorney with our physician consultant did not validate the denied claims; therefore, the overpayment remains unchanged. In determining payment pursuant to Medicaid policy, the Medicaid program utilizes procedure codes, descriptions, policies, limitations and requirements found in the Medicaid provider handbooks and Florida Statutes Section 409.913. In applying for Medicaid reimbursement, providers are required to follow the guidelines set forth in the applicable rules and Medicaid fee schedules, as promulgated in the Medicaid policy handbooks and billing bulletins. Medicaid cannot pay for services that do not meet these guidelines. The following is our assessment-of why certain claims do not meet Medicaid requirements. A computer printout detailing the claims affected by this assessment is attached. EXHIBT_& RECEIVED NOV 27 2000 M visit A HGTEGRIIM at 2727 Mahan Drive - Mail Stop #6 w. c.State.fl.us Tallahassee, FL 32308 ere VIMUGIIL LN. JUL VID, LVL. “ AURUST 24, ZUUU REVIEW FINDINGS The following review determinations were made by applying Medicaid policy to the documentation obtained from your office at the request of the Agency for Health Care Administration, Medicaid Program Integrity. Our Consultant determined that the use of gamma globulin was not medically indicated. Furthermore, interlukin 2 is experimental and not FDA approved in the treatment of HIV infected adult patients. . Medicaid policy prohibits payment for experimental procedures or non-FDA approved drugs and requires that all services rendered to Medicaid recipients be medically necessary. Billings to and payments made by Medicaid for services relating to the infusion of the aforementioned drugs, plethysmography (procedure code 93 720) and prolonged physician service (procedure codes 99354-99355) have also been denied. If you concur with the amount of the overpayment, please submit a certified cashier’s check in the amount of $1,881,737.71. The check must be payable to the Florida Agency for Health Care Administration, not to any employee of the agency. Questions regarding payment should be directed to Ms. Willie Bivens, Medicaid accounts receivable, (850) 487-4298. To ensure proper credit, be certain your provider number is shown on your check. Please mail to: Agency for Health Care Administration Medicaid Accounts Receivable P.O. Box 13749 Tallahassee, Florida 32317-3749 You have the right to request a formal or informal hearing pursuant to section 120.569, FS. Ifa petition for formal hearing is made, the petition must be in compliance with rule section 28-106.201, F.A.C. Please note that rule section 28-106.201(2), F.A.C. specifies that the petition shall contain a concise discussion of specific items in dispute. Additionally you are hereby informed that if a request for a hearing is made, the request Or petition must be received within twenty-one (21) days of receipt of this letter,. It is important that a request for an informal hearing or a petition for a formal hearing be sent only to the following address: Mr. John A. Owens, Chief Medicaid Program Integrity Office of Inspector General Agency for Health Care Administration 2727 Mahan Drive Tallahassee, Florida 32308, MS-6 RECEIVED NOV 27 2000 MEDICAID PROGRAM INTEGRITY Vincent N. Jarvis, M.D. 3 August 24, 2000 Do not send requests or petitions to any other address. If a hearing request is not received within twenty-one (21) days from the date of receipt of this letter, the right to such hearing is waived, and repayment of the above stipulated overpayment will be due and payable at the end of that twenty-one (21) day period. Any questions you may have about this matter should be directed to: Art Williams, Medical/Healthcare Program Analyst, Agency for Health Care Administration, Office of the Inspector General, Medicaid Program Integrity, 2727 Mahan Drive, Tallahassee, Florida 32308, MS-6, telephone (850) 410-0759, CCG: ART: dt Enclosures Cc: Medicaid Accounts Receivable Medicaid Program Development Medicaid Program Integrity Administration Area Medicaid Office RECEIVED NOV 27 2000 MEDICAID PROGRAM INTEGRITY ( SIA UP KLURIVA AGENCY FOR HEALTH CARE ADMINISTRATION JEB BUSH, GOVERNOR RUBEN WinG-SHAW, JR. BRORETARY MEMORANDUM INISTRA: INTEROFFICE aon ARINGS pate: '\\2¢/00 Qa TO: he. Wi; (ams + Medicaid Program Integrity FROM: Cphadts, Medicaid Program Integrity Administration SUBJECT: PROVIDER: \ Jaeus, Vincent? N. de Ct A 71970 Od) Notice (# |) Of Period Of Timeliness For A Valid Hearing Request x For Your Initial AAL, Mailed/Hand=Delivered 08 (24/7 For Our 10-Day Extension AAL, Mailed i. No CMRR Has Been Returned As Of This Day Since Mailing Date. How Would You Like To Handle This? Xx 2. CMRR Postmarked ——————— Wes Returned 4 AS/A . 3. Delivery/Receipt Date: x Is On CMRR/Hemtehelives—secnmensesien, OF/Si(d) ts Not On CMRR. How Would You Like to Handle This? ~ XK ¢. The Zist Day Is C | [21(d0 . ‘ Is Extended By Sat./Sun./holidey To . ee Please verify dates and enumeration of timeliness-period and let me know of problems. Thank you. Med, Prog Int. Adm.((0 1800) — ee 2727 Mahan Drive - Mail Siop =6 Tallahasses. FL 32308 ° Visit ARCA Online ar www kc stare. ius it RENAN ADD Is your DAY “oO”. DAY "y" DAY.“ Unrrep States Po ICE HAS "Pay" als oH ed By: eh tal ion sghature (Addressee or Agent) PS Form 3811, December 1994 incent N. Jarvis,. uD. "1680 Michigan Avenue #820. “Miami: Beach, Florida ‘33139 3776654-01.. —37-1070-000 vs Sency For Health Care Adm & sh Medica Program Integrity/WG2 s 2727 Maban Drive - Tallahassee, FL 32308-5403 First-Class Mall! tage & Fees Paid Permit No. G-10 J ajr’’ “ish to receive the follow- in 7000 0600 0027 15225 4b. Service Type Koei Fa, 8. Addresset's Address (Ohly if requested and fee is paid) 102295-99-8-0273 + Domestic Return Receipt |

Docket for Case No: 00-005074