Petitioner: INNOVATIVE HEALTH CARE, INC.
Respondent: AGENCY FOR HEALTH CARE ADMINISTRATION
Judges: CLAUDE B. ARRINGTON
Agency: Agency for Health Care Administration
Locations: Miami, Florida
Filed: May 02, 2001
Status: Closed
Settled and/or Dismissed prior to entry of RO/FO on Thursday, October 18, 2001.
Latest Update: Nov. 19, 2024
STATE OF FLORIDA eon
DIVISION OF ADMINISTRATIVE HEARINGS
bhi ie
INNOVATIVE HEALTH CARE, INC.
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Petitioner, . : 4
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CASE NO. 01-1653 ch a
AUDIT CI NO. 00-1063-000- 3 :
STATE OF FLORIDA, : a
AGENCY FOR HEALTH CARE
ADMINISTRATION,
vs.
Respondent.
/
FINAL ORDER
THE PARTIES resolved all disputed issues and executed a Settlement
Agreement on phtmbsy 79 , 2002, 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 2. day of proverb , 2002,
in Tallahassee, Florida.
pale MD, Secretary
fr Rhine 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 IJ, Esquire
Agency for Health Care
Administration
(Interoffice Mail)
Craig A. Brand, Esquire
5201 Blue Lagoon Drive
Suite 720
Miami, Florida 33126
(U.S. Mail)
Claude B. Arrington
Administrative Law Judge
Division of Administrative Hearings
The DeSoto Building
1230 Apalachee Parkway
Tallahassee, Florida 32399-3060
Judy Hefren, Deputy Inspector General
Kelly Bennett, Medicaid Program Integrity
Willie Bivens, Finance and Accounting
CERTIFICATE OF SERVICE
1 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 /¢ day
of Detenjnce —, 2002.
4° *Lealand McCharen, Esquire
Agency Clerk
State of Florida
Agency for Health Care Administration
2727 Mahan Drive, Building #3
Tallahassee, Florida 32308-5403
(850) 922-5873
(UL éesue LZizb rAA duvveDetuY DIAN As Or basa ta near nee
_ Unnovattve health Care
C.t Na: 00-1063-000
STATE OF FLORIDA
DIVISION OF ADMINISTRATIVE HEARINGS
INNOVATIVE HEALTH CARE, INC.,
Petitioner,
DOAH CASE NO: 01-1653
v. JUDGE: Claude B. Arrington
provider no.: 106627700
AGENCY FOR HEALTH CARE audit no.: CI 00-1063-000-3
ADMINISTRATION,
Respondent.
/
SETTLEMENT AG;CEEMENT
STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION
(“AHCA” or “the Agency”), and INNOVATIVE HEALTH CARE, INC. (“PROVIDER”), by
and through the undersigned, heroby stipulate and agroc as follows:
1. This Agreement is entered into berwcen 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 April 6, 2001 (the “Audit Letter”)
AHCA notified PROVIDER that review of Medicaid claims performed by the
Florida Medicaid Program through AHCA jndicated that, in its opinion, some
claims in whole or in pert were not covered by Medicaid. The Audit Letter
sought repayment from an invoice review that concluded that there were purchase
shortages in the amount of $441,743.05.
The purchase shortages, or invoice review, were based upon a review of
PROVIDER'S purchase snd dispensing records. The Agency initially sought
overpayment in the amount of $441,743.05.
In response to the Audit Letter, PROVIDER filed a petition for a formal
administrative hearing that was assigned DOAH Case No. 01-1653.
Subsequent to issuance of the Audit Letter, while PROVIDER denied the
allegations, PROVIDER submitted additional documentation and the parties met
to discuss and resolve all issues. Based upon the subsequent documentation,
AHCA determined the invoice shortage to be $299,259.81. PROVIDER disputes
AUCA'S determination, and believes there to be no shortage.
While PROVIDER continues to dispute AHCA’s determination, upon negotiation
between the parties, PROVIDER has agreed to settle in the amount of $240,000,
in terms as set forth in this agreement as full, final, and complete payment for all
amounts determined by AHCA to be an overpayment. AHCA has agreed to
accept $240,000 as full, final, and complete payment in this matter.
In order to resolve this matter without further administrative proceedings, and to
avoid the uncertainty of litigation, further outlay of resources and expense,
PROVIDER and AHCA expreasly agree a3 follows:
(A) AHCA agrees to accept the payment set forth herein in settlement of all
issues of overpayments arising from Audit No. CI 00-1063-000-3.
@) PROVIDER paid in October, 2001, one lump sum to AHCA of onc
bundred twenty
bnocvative health Care
C.L. No. 00- 1963-000
(C)
(@)
(E)
(F)
(G)
thousand dollars ($120,000.00) of the $240,000 to be paid pursuant to this
agreement.
PROVIDER has also paid the monthly payment for the months of
November, Decernber, and January, pursuant to this agrecment.
PROVIDER agrees to make three (3) more monthly payments of twenty
thousand dollars each ($20,000.00), plus interest, by the fifteenth day of
each consecutive month, begiming on February 15, 2001, as full and
complete settlement of the overpayment issue before the Division of
Administrative Hearings (DOAH Case No. 01-1653).
PROVIDER agrees that, pursuant to Florida Statutes, statutory interest
accrues, such that cach of the aforementioned payments shall be
$20,587.37, with exccption of the last payment of $20,587.35.
PROVIDER is responsible for ensuring timcly delivery of payments.
Furthermore, failure to timely make any payment, cither the first lump
sum or any of the monthly payments, will render the remaining
outstanding amount duc and payable immediately, with interest, and
interest will continue to accrue until the entire balance is paid, AHCA
reserves the right to seek eoforcement of this agreement by any legal
means.
PROVIDER also agrees to participate in education courres regarding
Medicaid billing. PROVIDER, Danny Zarsra, and his primary billing
employee shall, within six months of signing this agreement, attend and
successfully complete a course primarily designed to teach Medicaid
_nnovetive health Care .
CL No. : 00-1063-000
billing. PROVIDER agrees to provide written documentation of the
successful completion of the training 1o Key A-Bennett whose address
is listed above at paragraph 9.
CH) PROVIDER and AHCA agree that full payment as set forth above,
successful completion of the training, will resolve and settle this case
completely and release both parties from all liabilities arising from the
audit referenced as: C.L 00-1063-000-3 and that failure to do so may
result in the Agency pursuing all legal means to enforce this agreement,
may include a request for attorney fees and all costs associated with the
enforcement of this agreement, and may include adverse action toward
PROVIDER"S ability to participate in the Medicaid Program.
¢3) 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.
9. The monctary payment shall be made payzble to: AGENCY FOR
HEALTHCARE ADMINISTRATION
10. Each payment/check shall clearly indicate that it is per a settleroent agreement,
shall reference the DOAH Case Number, and shall reference the C.1, Number.
Payments shall be delivered to AHCA, Medicaid Accounts Receivable, ATTN:
Willie Bivens, Agency for Health Care ‘Administration, 2727 Mahan Drive,
Building 1, Tallahassee, Florida 32308-5403, or Post Office Box 13749,
Tallahassee, Florida 32317-3749.
User ceruc 1e-cey
Innovative health Care
C1 Na: 00-1063-000
12.
16.
PROVIDER agrees that failure to pay any monies duc and owing under the terms
of this Agreement shall constitute PROVIDER'S authorization for the Agency,
without further notice, to withbold the total remaining amount duc under the
terms of this egrecment from any monies due and owing to PROVIDER for any
Medicaid claims.
AHCA reserves the right to enforce this Agreement under the Jaws of the
State of Florida, the Rules of the Medicaid Program, and all other applicable rules
and regulations.
Each party shall bear its own attorneys” fees and costs, if any.
The signatories to this Agreement, acting in a representative capacity, represent
that they are duly authorized to entor into this Agreement on behalf of the
respective parties. Furthermore, PROVIDER agrecs that its representative
signature alone binds it to make payment, attend training, document compliance,
and submit the required documentation per the terms of this agreement, while this .
agreement is in process for signatures with AHCA.
However, if for any reason this agreement is not subsequently adopted by a Final
Order PROVIDER is no longer bound by its terms, Provider's monies paid shall
be insmediately returned and this agreement shall be deemed null and void. The
parties agree that ahe agreement is not adopted by a Final Order, the parties will
confer to continue negotiations, and if unsuccessful the matter shall be referred to
DOAH for an administrative bearing and the monies paid to AHCA by
PROVIDER hall be immediately refunded.
UL cerue
bore
Innovative haweh Care .
C.1 No: 00- 1063-000
17.
18.
19.
20.
21.
The parties further agree that a facsimile or photocopy reproduction of this
agreement with PROVIDER'S signature alone shall be sufficient for the Agency
to enforce the agreement AHCA will supply PROVIDER with a copy of the
fully excouted agreement as soon as it i¢ available.
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.
In the event that PROVIDER breaches this Agrecment, 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
PROVIDER to AHCA.
This Agreement constitutes the entire agreement between PROVIDER and
AHCA, including anyonc acting for, associated with or employed by them,
concerning aj] 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.
PROVIDER expressly waives in this case its right to any hearing pursuant to
Sections 120.569 or 120.57, Florida Statutes, the Agency making any findings of
fact and conclusions of law, and al) further and other procecdings to which it may
be entitled by law or rules of the Agency regarding this proceeding and any and
Inoovative health Care .
“C.L Ne: 00-1063-000
23.
24,
25.
INNOVA
all issues raised herein. PROVIDER further agrees that it shall not challenge or
contest any Final Order entered in this matter regarding the subject audit 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 xppeal.
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.
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
This Agreement shall joure to the benefit of and be binding on each party's
successors, assigns, heirs, administrators, representatives and trusiecs.
This Agreement shall be in full force and effect upon execution by the respective
parties in counterpart.
HEALTH CARE, INC.,
2 Rhyne hover peed: 2/2 , 2002
Danny Zarra, Owner/ President
Petitioner/Provide:
cme, >. ;
ae a pies, 22/2 , 2002
Craig A. Brand, uire,
Counsel for Petitioner/Provider
lmovative heath Care
CL Na: 00-1063-000
AGENCY FOR HEALTH CARE
ADMINISTRATION
2727 Mahan Drive, Mail Stop #3
Tallahassee, FL. 32308-5403
Docket for Case No: 01-001653
Issue Date |
Proceedings |
Dec. 06, 2002 |
Final Order filed.
|
Oct. 18, 2001 |
Order Closing File issued. CASE CLOSED.
|
Oct. 15, 2001 |
Settlement Agreement (filed by Respondent via facsimile).
|
Oct. 15, 2001 |
Motion to Cancel Hearing and Relinquish Jurisdiction (filed by Respondent via facsimile).
|
Oct. 05, 2001 |
AHCA`s Prehearing Statement (filed via facsimile).
|
Oct. 05, 2001 |
AHCA`s Response to petitioner`s Motion for Continuance (filed via facsimile).
|
Oct. 05, 2001 |
Motion for Continuance (filed by Petitioner via facsimile).
|
Oct. 03, 2001 |
Corrections to the Deposition of William Thomas (filed by Respondent via facsimile).
|
Oct. 02, 2001 |
Notice of Taking Deposition Duces Tecum, B. Coomes (filed via facsimile).
|
Oct. 01, 2001 |
Corrections to the Deposition of Mark A. Tripodi (filed by Respondent via facsimile).
|
Sep. 26, 2001 |
Respondent`s Response and objectins to Petitioner`s Second Request for Production of Documents (filed via facsimile).
|
Sep. 24, 2001 |
Notice of Taking Deposition Duces Tecum (filed by Respondent via facsimile).
|
Sep. 21, 2001 |
Notice of Taking Deposition Duces Tecum, B. Coomes (filed via facsimile).
|
Sep. 20, 2001 |
Notice of Taking Deposition, D.K. Yon, I. McKeague (filed via facsimile).
|
Sep. 20, 2001 |
Respondent`s Response to Petitioner`s First Set of Interrogatories (filed via facsimile).
|
Sep. 19, 2001 |
Notice to the Court Regarding Outstanding Discovery (filed by Respondet via facsimile).
|
Sep. 18, 2001 |
Innovative Health Care, Inc`s Second Request for Production (filed via facsimile).
|
Sep. 17, 2001 |
Order Denying All Pending Motions Except Motion to Continue Hearing and Order Requiring Joint Response to Pre-Hearing Order issued.
|
Sep. 17, 2001 |
Order Granting Continuance and Re-scheduling Hearing issued (hearing set for October 17 through 19, 2001; 9:00 a.m.; Miami, FL).
|
Sep. 17, 2001 |
Motion to Quash Subpoenas and Motion for Protective Order (filed by Respondent via facsimile).
|
Sep. 13, 2001 |
Notice of Filing Witnesses` Resumes or Curriculum Vitae (filed by Respondent via facsimile).
|
Sep. 13, 2001 |
Request for Reconsideration of Venue (filed by Respondent via facsimile).
|
Sep. 11, 2001 |
Motion to Strike Respondent`s Witnesses (filed by Petitioner via facsimile).
|
Sep. 11, 2001 |
Respondent`s Response to Petitioner`s Motions (filed via facsimile).
|
Sep. 11, 2001 |
AHCA`s Prehearing Stipulation (filed via facsimile).
|
Sep. 11, 2001 |
Amended Petition for Formal Hearing (filed by Petitioner via facsimile).
|
Sep. 11, 2001 |
Motion to Amend Petition (filed by Petitioner via facsimile)
|
Sep. 11, 2001 |
Motion for Continuance (filed by Petitioner via facsimile).
|
Sep. 10, 2001 |
Petitioner`s Prehearing Stipulation (filed via facsimile).
|
Sep. 10, 2001 |
Second Notice of Unavailability (filed by Petitioner via facsimile).
|
Sep. 10, 2001 |
Motion to Compel Election of Remedies (filed by Petitioner via facsimile).
|
Sep. 10, 2001 |
Notice of Objections to Depositions & Motion for Protective Order (filed by Respondent via facsimile).
|
Sep. 10, 2001 |
Respondent`s Response in Opposition to Innovative`s Notice of Unavailability (filed via facsimile).
|
Sep. 10, 2001 |
Subpoena for Final Hearing, J. Moses filed via facsimile.
|
Sep. 10, 2001 |
Subpoena for Deposition, J. Moses filed via facsimile.
|
Sep. 10, 2001 |
Notice of Taking Deposition, J. Moses (filed via facsimile).
|
Sep. 07, 2001 |
Notice of Unavailability (filed by Petitioner via facsimile).
|
Sep. 07, 2001 |
Motion for Bifurcated Hearing and Partial Continuance (filed by Petitioner via facsimile).
|
Sep. 07, 2001 |
Motion for Sanctions (filed by Petitioner via facsimile).
|
Sep. 06, 2001 |
Respondent`s Response to Petitioner`s First Request for Production (filed via facsimile).
|
Sep. 06, 2001 |
Respondent`s Response to Petitioner`s First Request for Admissions (filed via facsimile).
|
Sep. 06, 2001 |
Respondent`s Response to Petitioner`s First Set of Interrogatories (filed via facsimile).
|
Sep. 06, 2001 |
Petitioner`s Notice of Filing (filed via facsimile).
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Aug. 17, 2001 |
Notice of Telephone Hearing (filed by Petitioner via facsimile).
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Aug. 16, 2001 |
Respondent`s Response to Motion to Compel (filed via facsimile).
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Aug. 16, 2001 |
Respondent`s Respone to Motion for Continuance (filed via facsimile).
|
Aug. 16, 2001 |
Respondent`s Response to Petitioner`s First Request for Admissions (filed via facsimile).
|
Aug. 16, 2001 |
Respondent`s Response to Petitioner`s First Request for Production (filed via facsimile).
|
Aug. 15, 2001 |
Motion for Continuance (filed by Petitioner via facsimile).
|
Aug. 15, 2001 |
Motion to Compel (filed by Petitioner via facsimile).
|
Aug. 10, 2001 |
Notice of Objections to Depositions & Motion for Protective Order (filed by Respondent via facsimile).
|
Aug. 08, 2001 |
Notice of Taking Deposition K. Holland, K. Yon, G. Marsh (filed via facsimile).
|
Aug. 08, 2001 |
Notice of Taking Deposition C. Ginn, J. Jackson (filed via facsimile).
|
Jul. 24, 2001 |
Notice of Taking Deposition G. Beller, W. Thomas, M. Tripodi (filed via facsimile).
|
Jul. 16, 2001 |
Respondent`s Amended Witness List (filed via facsimile).
|
Jul. 11, 2001 |
Deposition of Daniel Zarra filed.
|
Jul. 11, 2001 |
Notice of Filing (deposition of D. Zarra) filed by Respondent.
|
Jul. 11, 2001 |
Respondent`s Witness List filed.
|
Jul. 11, 2001 |
Innovative`s First Set of Interrogatories (filed via facsimile).
|
Jul. 11, 2001 |
Notice of Service of Innovative`s First Set of Interrogatories (filed via facsimile).
|
Jul. 11, 2001 |
Petitioner`s Notice of Filing (filed via facsimile).
|
Jul. 11, 2001 |
Innovative`s First Set of Requests for Production (filed via facsimile).
|
Jul. 11, 2001 |
Innovative`s First Set of Request for Admissions (filed via facsimile).
|
Jul. 09, 2001 |
Innovative`s First Set of Requuests for Admissions (filed via facsimile).
|
Jul. 09, 2001 |
Innovative`s First Set of Interrogatories (filed via facsimile).
|
Jul. 09, 2001 |
Notice of Service of Innovative`s First set of Interrogatories (filed via facsimile).
|
Jul. 09, 2001 |
Innovative`s First set of Requests for Production (filed via facsimile).
|
Jul. 09, 2001 |
Innovative`s Preliminary Witness List (filed via facsimile). |
Jul. 06, 2001 |
Respondent`s Response to Petitioner`s Motion for Protective Order, Second Motion for an Order to Compel Complete Answers to Discovery Requests, and Second Motion to Compel Compliance with Subpoenas Duces Tecum and, in the Alternative, Motion for an Order which Precludes Evidence and Testimony (filed via facsimile).
|
Jul. 05, 2001 |
Motion for Protective Order on Behalf of Innovative Health Care, Inc., and Its Employees Regarding Subpoenas Duces Tecums (filed via facsimile).
|
Jul. 05, 2001 |
Innovative`s Objections to Interrogatories (filed via facsimile).
|
Jul. 05, 2001 |
Objections to Subpoena Duces Tecums on Behalf of Innovative Health Care, Inc., and Its Employees (filed via facsimile).
|
Jul. 05, 2001 |
Notice of Taking Deposition Duces Tecum (K. Christopher, C. Fennell, M. Mincieli, and D. Zarra) filed via facsimile.
|
Jun. 26, 2001 |
Notice of Filing (filed by Respondent via facsimile).
|
Jun. 26, 2001 |
Notice of Second Service of Interrogatories (filed via facsimile).
|
Jun. 22, 2001 |
Order Granting Continuance and Re-scheduling Hearing issued (hearing set for September 20 and 21, 2001; 10:00 a.m.; Miami, FL).
|
Jun. 20, 2001 |
Respondent`s Motion for an Order to Compel Complete Answers to Discovery Requests (filed via facsimile)
|
Jun. 20, 2001 |
Respondent`s Motion for Continuance (filed via facsimile).
|
Jun. 18, 2001 |
Respondent`s Response to Petitioner`s Objections to Subpoena Duces Tecum and Renewed Motion to Compel (filed via facsimile).
|
Jun. 15, 2001 |
Objections to Subpoena Duces Tecum (of D. Zarra) filed via facsimile.
|
Jun. 14, 2001 |
Respondent`s Motion for an Order ot Compel Production of Documents (filed via facsimile).
|
Jun. 11, 2001 |
Petitioner`s Response to Respondent`s First Request for Admissions filed.
|
Jun. 11, 2001 |
Petitioner`s Objections to Respondent`s Interrogatories filed.
|
Jun. 11, 2001 |
Petitioner`s Response to Respondent`s First Request for Production of Documents filed.
|
May 29, 2001 |
Order of Pre-hearing Instructions issued.
|
May 29, 2001 |
Notice of Hearing issued (hearing set for July 9 through 11, 2001; 10:30 a.m.; Miami, FL).
|
May 08, 2001 |
Petitioner`s Response to Initial Order (filed via facsimile).
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May 07, 2001 |
Respondent`s First Request for Production of Documents (filed via facsimile).
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May 07, 2001 |
Respondent`s First Request for Admissions (filed via facsimile).
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May 07, 2001 |
Notice of Service of Interrogatories (filed via facsimile).
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May 07, 2001 |
Respondent`s Response to Initial Order (filed via facsimile).
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May 02, 2001 |
Petition for Formal Hearing filed.
|
May 02, 2001 |
Final Agency Audit Report filed.
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May 02, 2001 |
Notice (of Agency referral) filed.
|
May 02, 2001 |
Initial Order issued.
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