STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION ERIC O. PANTALEON, Petitioner, vs. DOAH CASE NO. 01-1343 Audit No. CI-No. 97-1774-000 Rendition No. AHCA-01-192_-S-MDO AGENCY FOR HEALTH CARE ADMINISTRATION, Respondent. / FINAL ORDER THE PARTIES resolved all disputed issues and executed a settlement agreement 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 fileis CLOSED. DONE AND ORDERED on this the 22 fray of Tf } _, 2001, in Tallahassee, Florida. Z 7 Laura Br , Acting Secretary f 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: John Dennison, Esquire 1580 Sawgrass Corporate Parkway, Suite 130 Sunrise, Florida 33323 Kelly A. Bennett Assistant General Counsel Agency for Health Care Administration 2727 Mahan Drive, Mail Stop #3 Tallahassee, Florida 32308-5403 John G. VanLaningham 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 " Finance & Accounting hia tea CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the foregoing has been furnished to the above named addresses by U.S. Mail on thisthe ab day of 2001. RS. Power, Esquire Agency Clerk Agency for Health Care Administration 2727 Mahan Drive, Mail Stop #3 Tallahassee, Florida 32308-5403 (850)-922-5865 STATE OF FLORIDA DIVISION OF ADMINISTRATIVE HEARINGS ERIC O. PANTALEON, Petitioner, DOAH CASE NO: 01-1343 v. JUDGE: J. G. Van Laningham provider no.: 373453600 AGENCY FOR HEALTH CARE audit no.: CI 97-1774-000 ADMINISTRATION, Respondent. / SETTLEMENT AGREEMENT STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION (“AHCA” or “the Agency”), and ERIC O. PANTALEON (“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. 2. PROVIDER is a Medicaid provider in the State of Florida. 3. In its Final Agency Audit Report issued on February 9, 2001 (the "Audit Letter") 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 oseepayment in the amount of $50,571.57. In response to the Audit Letter, PROVIDER filed a petition for a formal administrative hearing that was assigned DOAH Case No. 01-1343. Subsequent to issuance of the Audit Letter, PROVIDER submitted. additional documentation and the parties met to discuss and resolve all outstanding issues. The parties agreed that the amount of overpayment was $38,006.44 4. In order to resolve this matter without further administrative proceedings, PROVIDER and the AHCA expressly agree as follows: (1) (2) (3) 4) 6) AHCA agrees to accept the payment set forth herein in settlement of the overpayment issues arising from the MPI review. Within thirty days of receipt of a fully executed copy of this Agreement, PROVIDER agrees to pay to AHCA the sum of thirty-six thousand dollars ($36,000.00) to be made in one lump sum payment, as full and complete settlement of all claims in the proceedings before the Division of Administrative Hearings (DOAH Case No. 01-1343). . 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.L. 97-1774-000 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. PROVIDER agrees that failure to make payment per the terms of this agreement may result in the Agency pursuing all legal means to enforce this agreement and may include a request for attorney fees and all costs associated with the enforcement of this agreement. 5. Payment shall be made to: AGENCY FOR HEALTHCARE ADMINISTRATION Medicaid Accounts Receivable Post Office Box 13749 Tallahassee, Florida 32317-3749 And payment shall clearly indicate that it is per a settlement agreement, shall reference the DOAH Case Number, and shall reference the C.J. Number. 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 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 and costs, 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 j ointly 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. Be ee FRE eg Rufus N 18. This Agreement shall inure to the benefit of and be binding on each party’s euecsiche: 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. ERIC O, PANTALEON, M.D. Dated: CSE 2001. by ' Dated: 7 2001 Jo 7“ Dennison oe Fes sel for Pettione/Provider AGENCY FOR HEALTH CARE ADMINISTRATION =~ 2727 Mahan Drive, Mail Stop #3 Tallahassee, FL 32308-5403 * 2001 bble Inspector General _

Docket for Case No: 01-001343