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CEDARS MEDICAL CENTER vs AGENCY FOR HEALTH CARE ADMINISTRATION, 02-001968MPI (2002)

Court: Division of Administrative Hearings, Florida Number: 02-001968MPI Visitors: 14
Petitioner: CEDARS MEDICAL CENTER
Respondent: AGENCY FOR HEALTH CARE ADMINISTRATION
Judges: PATRICIA M. HART
Agency: Agency for Health Care Administration
Locations: Miami, Florida
Filed: May 14, 2002
Status: Closed
Settled and/or Dismissed prior to entry of RO/FO on Thursday, May 30, 2002.

Latest Update: Dec. 23, 2024
STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION CEDARS MEDICAL CENTER, b HL ~obeue Petitioner, DOAH Case No.: 02-1968MPI C.L. 97-1306-127 v. _AHCA Provider No.: 10036600 8 Perel Ae AHA OS CHOW MD P STATE OF FLORIDA, 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. jacks . i yp DONE AND ORDERED on this the _ | 4 day of L7AIDCUAE. , 2003, in J Rhonda M. Medows, , secre! Agency for Health Care Administration Tallahassee, Florida. 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: Peter M. Feaman, Esquire Jeffrey T. Royer, Esquire Buckingham, Doolittle and Burroughs 2500 N. Military Trail, Ste 480 Boca Raton, FL. 33431 (U.S. Mail) Susan Felker-Little, Esquire Senior Attorney Agency for Health Care Administration 2727 Mahan Drive, Mail Stop #3 Tallahassee, Florida 32308-5403 (Interoffice) Patricia H. Malono Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (Interoffice) Bob Maryanski, Program Administrator Medicaid Program Development Agency for Health Care Administration 2727 Mahan Drive Tallahassee, Florida 32308 (Interoffice) Finance & Accounting (Interoffice) CERTIFICATE OF SERVICE 1 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 / 142, “day of ‘Marlene x MEK foe Lealand McCharen, td Clerk Agency for Health Care Administration 2727 Mahan Drive, Mail Stop #3 Tallahassee, Florida 32308-5403 (850) 922-5873 03 FEB 20 AM 9:37 STATE OF FLORIDA ney ont EV Gare AGENCY FOR HEALTH CARE ADMINISTRATION ADMIN E! CEDARS MEDICAL CENTER, Petitioner, DOAH Case No. 02-1968MPI AHCA Provider No. 010036600 v. C.I, 97-1306-127 STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, Respondent. / SETTLEMENT AGREEMENT STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION (“AHCA” or “the Agency”), and CEDARS MEDICAL CENTER (“PROVIDER”), by and through the undersigned, hereby stipulate and agree as follows: 1. This Settlement Agreement (the “Agreement”) is entered into between the parties for the purpose of avoiding the costs and burdens of litigation, and neither party concedes the other’s position. 2. PROVIDER is a Medicaid provider in the State of Florida, with provider number 010036600. 3. In its Final Agency Audit Report dated March 25, 2002, AHCA notified PROVIDER that a retrospective review of Medicaid claims for inpatient hospital admissions for mental disorder diagnoses, performed by First Mental Health, Inc., indicated that, in its opinion, some claims submitted by PROVIDER were not covered by Medicaid in whole or in part. The Agency sought overpayment in the amount of Twenty-Seven Thousand Two Hundred Fifty-Nine Cedars Medical Center v. AHCA DOAH Case No.02-1968MPI AHCA PROVIDER NO. 010036600 C.1. 97~-1306-127 SETTLEMENT AGREEMENT Page 2 of 6 Dollars and Eighteen Cents ($27,259.18). In response to the Final Agency Audit Report, PROVIDER filed a Petition for a Formal Administrative Hearing, the matter was referred to the Division of Administrative Hearings (DOAH), and DOAH assigned the matter DOAH Case No. 02-1968MPI. 4, Thereafter, the parties entered into settlement negotiations, the parties filed a Joint Motion to Relinquish Jurisdiction in DOAH, and DOAH entered an order closing its file and referring the matter back to AHCA for completion of settlement. 5. In order to resolve this matter without further administrative proceedings, PROVIDER and AHCA expressly agree as follows: (a) AHCA agrees to accept the payment set forth herein in settlement of the overpayment issues arising from the First Mental Health, Inc. review. (b) Within thirty (30) days of receipt of the Agency for Health Care Administration Final Order incorporating by reference this Settlement Agreement, PROVIDER shall make a single payment in the total sum of TWENTY-TWO THOUSAND DOLLARS AND NO CENTS ($22,000.00) (the “Settlement Amount”) in Full and Final settlement of all claims in these proceedings referenced as C.I. 97-1306-127 (c) The Settlement Amount will be made payable and remitted to: Agency for Health Care Administration Attn. Medicaid Accounts Receivable P. O, Box 13749 Tallahassee, FL 32317-3749 Payment shall clearly indicate that it is pursuant to a settlement agreement and shail reference Audit C.I. 97-1306-127. Cedars Medical Center v. AHCA DOAH Case No.02-1968MPI AHCA PROVIDER NO. 010036600 CI. 97-1306-127 SETTLEMENT AGREEMENT Page 3 of 6 (d) | PROVIDER and AHCA agree that full payment of the Settlement Amount as set forth above will resolve and settle this case completely and release both parties from all liabilities arising from the findings in the audit referenced as C.I. 97-1306-127. (e) PROVIDER is responsible for ensuring timely delivery of the Settlement Amount set forth herein. Furthermore, failure to timely make the payment will render the balance due and payable immediately, with statutory interest, and interest will continue to accrue until the entire balance is paid. AHCA reserves the right to seek enforcement of this agreement by any legal means. (f) If AHCA offsets, inadvertently or otherwise, all or a portion of the Settlement Amount from any future Medicaid reimbursement payable to PROVIDER (except as authorized by paragraph 6 below), AHCA agrees PROVIDER may credit the amount of any such offset against the Settlement Amount at the time PROVIDER tenders such payment. (g) 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. 6. PROVIDER agrees that failure to pay any monies due and owing under the terms of this Agreement shall constitute PROVIDER’s authorization for the Agency, without further Cedars Medical Center v. AHCA DOAH Case No.02-1968MPI AHCA PROVIDER NO. 010036600 CLL. 97-1306-127 SETTLEMENT AGREEMENT Page 4 of 6 notice, to withhold the total remaining amount due under the terms of this Agreement from any monies due and owing to PROVIDER for any Medicaid claims. 7. 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. 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. The parties agree to bear their own attorney’s fees and costs, if any, except as hereinabove stated. 10. 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. 11. 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. 12, This 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 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 setting any potential correctness or Cedars Medical Center v. AHCA DOAH Case No.02-1968MPI AHCA PROVIDER NO. 010036600 C.1. 97-1306-127 SETTLEMENT AGREEMENT Page 5 of 6 incorrectness of its understandings, information and contentions as to facts and law, so that no misunderstanding or misinformation shall be a ground for rescission hereof. 14. PROVIDER expressly waives in this matter its right 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, including appeals, to which it may be entitled by law or rules of the Agency regarding this proceeding and any and all issues raised herein. PROVIDER further agrees that it shall not challenge or contest any Final Order entered in this matter that is consistent with the terms of this 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 appeal. 15, 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. 16. 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. 17. This 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 Agreement. 19. This Agreement shall be in full force and effect upon execution by the respective parties in counterpart. Cedars Medical Center v. AHCA DOAH Case No.02-1968MPI AHCA PROVIDER NO. 010036600 Cu. 97-1306-127 SETTLEMENT AGREEMENT Page 6 of 6 AGENCY FOR HEALTH CARE ADMINISTRATION 2727 Mahan Drive, Mail Stop #3 Tallahassee, FL 32308-5403 Pree Dated: @ , 2008 BOB SHARPE Deputy Secretary, Medicaid ho ee CHRISTIAN Efe Lf VALDA CLARK General Counsel } . 3 f/f, z / : tia Dated: ~/ 2 , 2002. SUSAN C. FELKER-LITTLE Assistant General Counsel CA} ~ «CL2:164172_4»

Docket for Case No: 02-001968MPI
Source:  Florida - Division of Administrative Hearings

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