AIS 16 02 STATE OF FLORIDA cern kif one AGENCY FOR HEALTH CARE ADMINISTRATION 3s 27 a os -_ oe wo te THE BARRANCO CLINIC, e iit 7 = Oo Petitioner, DOAH CASE NO.: 02-1962 Vv. bm ) STATE OF FLORIDA, cheawk AGENCY FOR HEALTH CARE ADMINISTRATION, Respondent. FINAL ORDER THE PARTIES resolved all disputed issues and executed a Settlement Agreement, which is attached hereto and incorporated herein 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 ot Sfeaat 2002, in Tallahassee, Florida. Rhond. . 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: SUSAN C. FELKER-LITTLE, Esquire Assistant General Counsel Agency for Health Care Administration (“(AHCA”) (Interoffice Mail Stop #3) Faye L. Zelonky Barranco Insurance Department 160 East Lake Howard Drive Winter Haven, FL 33881-3100 Bob Sharpe, Deputy Secretary, Medicaid I HEREBY CERTIFY that a true and correct copy of the foregoing has been furnished to vot, 2002' = the above named addressees by U.S. Mail on this the | b Hay of dws 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 B58 921 O153 F.d2 FIN-L8-29BZ 22:42 AGENCY HEALTH CARE ADITIM The Barranco Clinic DOAH Case No. 02-1962 Provider No. 253008200 Deane R. Briggs, M.D. Provider No, 057927100 SETTLEMENT AGREEMENT STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION (“AHCA"” or “the Agency”), The Barranco Clinic (“PROVIDER”), and Deane R. Briggs, MD. (“SECOND PROVIDER”), by and through the undersigned, hereby stipulate and agree as follows: 1. This Agreenient 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 (a group provider), with provider number 253008200. SECOND PROVIDER is a Medicaid provider in the State of Florida (individual provider), with provider number 057927100, who performs services within PROVIDER’S group. 3. PROVIDER submitted a claim of $3,400.00 for the payment of services provided by SECOND PROVIDER on April 15, 1998 for a patient with Medicaid number 2453133101 7 (“the CLAIM”), which AHCA denied for various reasons. After requesting assistance from : different AHCA employees to try to resolve this issue, PROVIDER submitted a request for an informal hearing, which was received by AHCA on April 15, 2002. AHCA referred the matter to DOAH for a formal administrative hearing because it appeared there were disputed issues of matenial fact JIR-18-2882 22:05 AGENCY HEALTH CARE ALIN 8560 Sel GL53 F.as 4. PROVIDER submitted additional information to AHCA. Further, PROVIDER verbally inforrned AHCA that PROVIDER desired payment to be made to SECOND PROVIDER, not to PROVIDER. 5. In order to resolve this matter without further administrative proceedings, PROVIDER, SECOND PROVIDER, and AHCA expressly agree as follows: (a) PROVIDER agrees that SECOND PROVIDER is the appropriate Medicaid provider to whom payment of the CLAIM should be made. (b) AHCA has agreed to remit payment in the amount of $3,400.00 as payment in full for the CLAIM. Further, in fact, AHCA has remitted payment in full to SECOND PROVIDER. PROVIDER and SECOND PROVIDER acknowledge, by their signature on this Settlement Agreememt, SECOND PROVIDER’S receipt of payment in full of the CLAIM. (c) PROVIDER, SECOND PROVIDER, and AHCA agree that full payment as set forth in subparagraph 5.(b) above resolves and settles this case completely and releases all parties from all liabilities arising in this matter. 6. 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. to A ls JH-ie-2802 22:03 AGENCY HEALTH CARE ADMIN 85@ 921 153 P.a4 7. This settlement does not constizute an admission of wrongdoing or error by either parry with respect to this case or any other matter, 8. The parties agree to bear their own attomey’s fees and costs, if any. 9. 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. 10. 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. il. | This Agreement constitutes the entire agreement between PROVIDER, SECOND 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, SECOND 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 Agreement 1s completed and properly executed by PROVIDER, SECOND PROVIDER, and AHCA, 12. 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 lew, and with each party compromising and settling any potential correctness or TAL Oe e2:az AGENCT HEALTH CARE ADMIN B22 Gel Gisa P.a5 nt De] PS a incorrectness of tts understandings, information and contentions 4s to facts aud law, so that no misunderstanding or misinformation shall be a ground for rescission hereof. 13. PROVIDER and SECOND PROVIDER expressly waive in this matter their rights 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 they may be entitled by law or rules of the Agency regarding this proceeding and any and al issues raised herein. PROVIDER and SECOND PROVIDER further agree that they shall not challenge or contest any Final Order entered in this matter that is consistent with the terms of this settlement in any forum now or in the future available to them, including the nght to any administrative proceeding, circuit or federal court action or any appeal. 14, 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. 1S. To the extent that any provision of this Agreement is prohibited by law, for any reason, such provision shall de effective to the extent not so prohibited, and such prohibition shall not affect any other provision of this Agreement. 16. This Agreement shall inure to the benefit of and be binding on each party’s successors, assigns, heirs, administrators, representatives and trustees. 17. Ail times stated herein are of the essence of this Agreement. - TUN-L8-Z2992 22:34 AGENCY HEALTH CARE ADMIN 829 921 9158 P.06 18. This Agreement shall be in full force and effect upon execution by the respective parties in counterpart. PROVIDER: TRE BARRANCO CLINIC —Phut Quam TITLE: Bam W'S WA o__ SECOND PROVIDER: DEANE R. BRIGGS, M.D AGENCY FOR HEALTH CARE ADMINISTRATION 2727 Mahan Drive, Mail Stop #3 Tallahassee, FL 32308. Pro.e BOB SHARPE Deputy Secretary, Medicaid WILLIAM ROBERTS Acting General Counsel ~ FELKER-LITILE. Assistam General Counsel ud) Dated: G-}G-O aa 2002, Dated: 6 J 7) , 2002, , 2002. Dated: AZ = 3 , 2002. “3 Dated; Tune. a 4- 2002. TOTAL P.@6

Docket for Case No: 02-001962