STATE OF FLORIDA OCT 16 02 AGENCY FOR HEALTH.CARE ADMINISTRATION AHCA NEPARTE TNT CLERK HOLY CROSS HOSPITAL, Of QO Petitioner, a up lonecl = nm : .. vs. => DOAH CASE NOS. 02:7308MPF= 02-0584MPFL AUDIT NOS. C.I. 01-0974-000 C.1. 01-1037-000 = wo “ STATE OF FLORIDA, mA 3 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 file is CLOSED. DONE AND ORDERED on this the_| CP day of ( CTO PSEC, 2002, in Tallahassee, Florida. Rhonda M. Medows, MD, Secretary 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: H. Darrell White, Esquire McFarlain & Cassedy, P.A. 215 S. Monroe Street, Ste. 600 Tallahassee, FL 32301 Grant P. Dearborn, Assistant General Counsel Agency for Health Care Administration 2727 Mahan Drive, Mail Stop #3 Tallahassee, Florida 32308-5403 (Interoffice) Kim Kellum, Assistant General Counsel Agency for Health Care Administration 2727 Mahan Drive, Mail Stop #3 Tallahassee, Florida 32308-5403 (Interoffice) Charles Ginn Medicaid Program Integrity Agency for Health Care Administration 2727 Mahan Drive, MS #5 Tallahassee, Florida 32308 (Interoffice) Willie Bivins Finance & Accounting Medicaid Accounts Receivables Agency for Health Care Administration 2727 Mahan Drive, MS #14 (Interoffice) Robert Maryanski Medicaid Program Development Agency for Health Care Administration 2727 Mahan Drive, MS #20 (Interoffice) Saduuiniatemtive haaw dom tt uiclge ~ CERTIFICATE OF SERVICE RENEE SS 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 this the re day of { y Ek EL, , 2002. ChaceneTIRA ESS - CLealand McCharen, Esquire Agency Clerk Agency for Health Care Administration 2727 Mahan Drive, Mail Stop #3 Tallahassee, Florida 32308-5403 (850) 922-5873 STATE OF FLORIDA 00 _. AGENCY FOR HEALTH CARE ADMINISTRATION “C7 3, - ‘ . an AN o HOLY CROSS HOSPITAL, INC., “1G Petitioner, a vs. DOAH CASE NOS.; 02-1308MPI ; 02-0584MPI STATE OF FLORIDA, AGENCY FOR AUDIT NOS.: CI. 01-0971-000 HEALTH CARE ADMINISTRATION, CL 01-1037-000 Respondent. / SETTLEMENT AGREEMENT The State of Florida, Agency for Health Care Administration (“AHCA"), and Holy Cross Hospital, Inc. (‘PROVIDER’), stipulate and agree as follows: 1. This Agreement is entered into between the parties for the purpose of avoiding the costs and burden of litigation, and neither party concedes the other's position. 2. PROVIDER is a Medicaid provider in the State of Florida. 3. In its Final Agency Audit Reports C.I. 01-0971-000 and C.I. 01-1037-000, AHCA notified PROVIDER that a review of Medicaid claims performed by Medicaid Program Integrity (MP1) indicated some claims submitted by PROVIDER were not covered by Medicaid, either in whole or in part. The Agency sought to recoup overpayments in the amount of $43,085.08 and $43,164.66. In response, PROVIDER petitioned for a formal administrative hearing, which matter was referred in two of the audits to the Division of Administrative Hearings and given DOAH Case Nos. 02-0584MPI and 02-1308MPI. Subsequently and after additional information was provided, AHCA reviewed the disputed claims and determined the outstanding amount of overpayment should be reduced to $53,352.66. 4. In order to resolve this matter without further administrative proceedings, AHCA and PROVIDER expressly agree as follows: a. AHCA agrees to accept the payment set forth herein in settlement of the overpayment issues arising from this MPI review. b. AHCA filed with DOAH a Motion to Relinquish Jurisdiction and was authorized to represent PROVIDER’s concurrence in the motion. c. Upon remand of this matter from DOAH, AHCA will enter a Final Order incorporating the terms of this Settlement Agreement. d. Within thirty (30) days of receipt of the Final Order, PROVIDER agrees to make a single payment to AHCA of Fifty-Three Thousand Three Hundred Fifty-Two and 66/100 Dollars ($53,352.66) in full and complete settlement of all claims in these proceedings. e. PROVIDER and AHCA agree 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 audits referenced as C.I. 01-0971-000 and C.I. 01-1037-000. f. PROVIDER agrees it will not re-bill the Medicaid Program in any manner for claims which are the subject of the audits in these cases. 5. Payment shall be made to: AGENCY FOR HEALTHCARE ADMINISTRATION Medicaid Accounts Receivable Post Office Box 13749 Tallahassee, Florida 32317-3749 6. PROVIDER agrees the failure to pay any monies due and owing under the terms of this Settlement Agreement shall constitute PROVIDER'S authorization for AHCA, without further notice, to withhold the total remaining amount due under the terms of this Settlement Agreement from any monies due and owing PROVIDER for any Medicaid claims. 7. AHCA reserves the right to enforce this Settlement Agreement under Florida law, 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. 9. Each party shall bear its own attorneys’ fees and costs. 10, Each party to this Settlement Agreement stipulates its undersigned representative is duly authorized to enter into and execute this Settlement Agreement on its behalf. 11. This Settlement Agreement shall be construed in accordance with Florida law. Venue for any action arising from this Settlement Agreement shall be in Leon County, Florida. 12. This Settlement Agreement constitutes the entire agreement between PROVIDER and 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 AHCA other than as set forth herein. No modification or waiver of any provision shall be valid unless a written amendment to the Settlement Agreement is completed and properly executed by the parties. 13. 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 understanding, information, and contention as to fact and law, so that no misunderstanding or misinformation shall be a ground for rescission of this Settlement ‘Agreement. . 14. | PROVIDER expressly waives in this matter its right to any hearing under §§ 120.569 or 120.57, Florida Statutes, the making of findings of fact and conclusions of law by AHCA, and all other proceedings, including appeals, to which it may be entitled by law regarding any and all issues raised in this case. PROVIDER further agrees it shall not challenge or contest any Final Order which is consistent with the terms of this Settlement Agreement, waiving its rights to any administrative proceeding, state or federal court action, or any appeal. 15, This Settlement Agreement is and shall be deemed jointly drafted and written by all parties to it and shall not be construed or interpreted against either party. 16. To the extent any provision of this Settlement Agreement is prohibited by law for any reason such prohibition shall not affect any other provisions of this Settlement Agreement. 17, This Settlement Agreement shall inure to the benefit of and be binding on each party's successors, assigns, heirs, administrators, representatives, and trustees. 18. All times stated herein are of the essence of this Settlement Agreement. 19. This Settlement Agreement shall be in full force and effect upon execution by the respective parties in counterpart. 20. Petitioner for itself and for its related or resulting organizations, its successors or transferees, attorneys, heirs, and executors or administrators, does hereby discharge the State of Florida, Agency for Health Care Administration, and its agents, representatives, and attorneys, of and from all claims, demands, actions, causes of action, suits, damages, losses, and expenses, of any and every nature whatsoever, arising out of or in any way related to Audit Nos. C.I. 01-0971-000 and C.1. 01-1037-000. 21. The Agency for itself, its agents, representatives, and attorneys, does hereby discharge Holy Cross Hospital, Inc., and its related of resulting organizations, its successors or transferees, attorneys, heirs, and executors or administrators, of and from all claims, demands, actions, causes of action, suits, damages, losses, and expenses, of any and every nature whatsoever, arising out of or in any way related to Audit Nos. C.I. 01-0971-000 and CI. 01-1037-000. HOLY CROSS HOSPITAL Dated: August 15, By: John C. Johnson, President & CEO (Print name) FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION 2727 Mahan Drive, Mail Stop #3 Tallahassee, FL 32308-5403 2002 ~ pme> —e Dated: Z , 2002 Bob Sharpe, Deputy Secretary, Medicaid Lijit eB eA , 2002 WittiamrH- Roberts, Acting General Counsel Vo lola Clark Chnshbn WEP Qk — Grant P. Dearborn, Assistant General Counsel Joe Rin Kim Kellum, Assistant General Counsel we Rufus Noses, Inspector General Dated: AVG. /4 , 2002 Dated: Cunguit | i , 2002 DATED: _ sfey 2092

Docket for Case No: 02-001308MPI