STATE OF FLORIDA 03° AGENCY FOR HEALTH CARE ADMINISTRATION OPTICA EL ENCANTO, Petitioner, Vs. AGENCY FOR HEALTH CARE ADMINISTRATION, Respondent. DOAHCASENO. 01-40simPr YIN AUDIT NO. C1. 00-1787-000 4 , PROVIDER NO. 254925500 CLOPA FINAL ORDER This cause was referred to the Division of Administrative Hearings and assigned ' t to an Administrative Law Judge (ALJ) for a formal administrative hearing and the entry , of a Recommended Order. The ALJ entered an order closing the Division’s file and relinquishing jurisdiction to the Agency on July 19, 2002. The Agency filed a motion to re-open the case on September 12, 2002. The Agency filed a motion for summary recommended order on September 30, 2002. An Order Denying Motion to Re-Open and Denying Motion for Summary Recommended Order was issued by the ALJ on October 4, 2002, and is attached to this Final Order and incorporated herein by reference. IT IS THEREFORE ADJUDGED THAT: There now being no disputed issues of fact in this case, the Agency has Jurisdiction to render a final order in the cause. Petitioner shall repay a Medicaid overpayment of $87,768.78 plus statutory interest from the date of the Final Agency Audit Report. Such payment shall be made within thirty (30) days of the rendition of this final order. Payment shall be made to the Agency for Health Care Administration and sent to: Willie Bivens Medicaid Finance and Accounting Post Office Box 13749 Tallahassee, Florida 32317-3749 DONE and ORDERED this 9 day of ln, | , 2003, in Tallahassee, Florida. ~ RHONDA M. MEDOWS, MD., SECRETARY Agency rfl Care Administration NOTICE OF RIGHT TO JUDICIAL REVIEW A PARTY WHO IS ADVERSELY AFFECTED BY THIS FINAL ORDER IS ENTITLED TO JUDICIAL REVIEW, WHICH SHALL BE INSTITUTED BY FILING THE ORIGINAL NOTICE OF APPEAL WITH THE AGENCY CLERK OF AHCA, AND A COPY, ALONG WITH THE FILING FEE 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 THE RENDITION OF THE ORDER TO BE REVIEWED. CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the foregoing Final Order has been furnished by U.S. Mail, or by the method indicated, to the persons named below on this ut day of ChOACl , 2003. Chyartee Ope picry 4€ Lealand L. McCharen, Agency Clerk Agency for Health Care Administration 2727 Mahan Drive, MS #3 Tallahassee, FL 32308-5403 COPIES FURNISHED TO: } J.D. Parrish Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, FL 32399-3060 William Porter, Esquire Agency for Health Care Administration 2727 Mahan Drive, MS #3 Tallahassee, FL 32308 Jerry Velazquez, Esquire 900 West 49" Street, Suite 430 Hialeah, FL 33012 Kelly A. Bennett, Assistant Bureau Chief Medicaid Program Integrity Willie Bivens Finance and Accounting

Docket for Case No: 01-004081MPI