STATE OF FLORIDA eon DIVISION OF ADMINISTRATIVE HEARINGS bhi ie INNOVATIVE HEALTH CARE, INC. fio 1 Petitioner, . : 4 7 Ne o 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