STATE OF FLORIDA DIVISION OF ADMINISTRATIVE HEARINGS FLORIDA HOSPITAL ORLANDO, Petitioner, CASE NO. 02-3477MPI_ VE QC LOY ek AUDIT NO. C.I. 00-1160-000 . RENDITION NO.: AHCA-03-0381-S~MDP vs. 2 STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, Respondent. / FINAL ORDER THE PARTIES resolved all disputed issues and executed a “settlement agreement”, which is incorporated by reference. The parties are directed to comply with the terms of the “settlement agreement”. Based on the foregoing, this proceeding is CLOSED. DONE and ORDERED on this the _\\___dayof__G \ ae, 2003, in Tallahassee, Florida. Rhonda M. Medows, M.D., Satretary 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: John D. Buchanan, Jr., Esquire Henry, Buchanan, Hudson, Suber & Carter, P.A. 117 South Gadsden Street Tallahassee, FL 32301 Jeffries Duvall, Esquire Attorney for Agency AGENCY FOR HEALTH CARE ADMINISTRATION 2727 Mahan Drive Fort Knox Building 3, Mail Stop 3 (Interoffice) Michelle Adamski, Analyst Medicaid Program Development 2727 Mahan Drive, Bldg. 3 MS #20 (Interoffice) Timothy Byrnes, Chief Medicaid Program Integrity 2002 Old St. Augustine Road (Interoffice) Judith E. Hefren Deputy Inspector General Medicaid Program Integrity (Interoffice) Willie Bivens, Finance and Accounting (nteroffice) W.F. Quattlebaum Administrative Law Judge DOAH (Interoffice) CERTIFICATE OF SERVICE I 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 \ ( ia _, 2003. be (hav 4 “ihe Cpu) sf re we Lealand Wh Ge Esquire Agency Clerk State of Florida Agency for Health Care Administration 2727 Mahan Drive, Building #3, Mail Stop 3 Tallahassee, Florida 32308-5403 STATE OF FLORIDA DIVISION OF ADMINISTRATIVE HEARINGS FLORIDA HOSPITAL ORLANDO, Petitioner, CASE NO. 02-3477 AUDIT NO. C.1. 00-1160-000 10/22/93-11/15/96 vs. STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, Respondent. / SETTLEMENT AGREEMENT STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION (“AHCA” or “the Agency”), and FLORIDA HOSPITAL ORLANDO, (“PROVIDER”), by and through the undersigned, hereby stipulate and agree as follows: 1. This Agreement is entered inte 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. 3. In its final agency audit report dated September 13, 2001, AHCA notified PROVIDER that review of Medicaid claims performed by Medicaid Program Integrity (MPI) indicated that, in its opinion, some claims in whole or in part were not covered by Medicaid. The Agency sought overpayment in the amount of $203,432.31. In response to the audit letter dated September 13, 2001, PROVIDER filed a petition for a formal administrative hearing, which was assigned DOAH Case No. 02-3477. Based upon information subsequently provided AHCA by the Petitioner, this amount was adjusted to $167,530.11. However, due to the unpredictability and the uncertainty of litigation, the parties have each agreed to compromise their position and have agreed that the amount of $80,000.00, plus $5,000.00 representing costs of investigation and litigation to the Agency, paid within 30 days of the finalization of this settlement agreement, will be acceptable by the Agency as full payment of audit number C.1. 00- 1160-000. 4. In order to resolve this matter without further administrative proceedings, PROVIDER and the AHCA expressly agree as follows: qd) AHCA agrees to accept the payment set forth herein in settlement of the overpayment issues arising from the MPI review. (2) Within thirty days of receipt of the final order, PROVIDER agrees to make a single payment of Eighty Five Thousand Dollars and zero cents ($85,000.00) in full and complete settlement of all claims in the proceedings before the Division of Administrative Hearings (DOAH Case No. 02-3477MPI). 7 (3) PROVIDER and AHCA agree that full payment as set forth above will resolve and settle this case completely and release both parties from all liabilities arising from the audit referenced as C.I. 00-1160-000. (4) 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. 5. Payment shall be made to: AGENCY FOR HEALTHCARE ADMINISTRATION Medicaid Accounts Receivable Post Office Box 13749 Tallahassee, Florida 32317-3749 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 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. Each party shall bear its own attorneys’ fees and costs, if any. 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 the 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 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. 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 potential correctness or 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 mght 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 proccedings 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 ccntest any Final Order entered in this matter 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 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. FLORIDA HOSPITAL ORLANDO can 2. Bvdle, Dated: 2 LZ _, 2003 BY:_ Atanic 6. Ria dle ITS: (ice PRudece rint name) Hu Duh __ Dated: af 3/0 OS _,2003 hn Buchanan, Esquire Attorney for Petitioner FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION 2727 Mahan Drive, Mail Stop #3 Tallahassee, FL 32308-5403 foe Valda Christian General Counsel Ke, ae CG, Ka) Mitte: We Kim Kellum Chief Medicaid Counsel .Duvall = Bob [ome Deputy Secretary, Medicaid Dated: Dated: Lrg ZL , 2003 re , 2003 —T a , 2003 tt General Counsel & FLORIDA AGENCY FOR HEALTH CARE ADMINSTRATION Gy, SOS - JEB BUSH, GOVERNOR RHONDA M MEDOWS, MD, FAAFR( SECRETARY A AO by PLEASE INCLUDE THIS REMITTANCE FORM WITH YOUR PAYMENT eee Al 4? C.I. No.: 00-1160-000 Provider No.: 010129001 Audit Dates: Name of Entity: Florida Hospital Orlando Address: 601 East Rollins Street, Orlando, FL 32803 Amount to be Paid: $85,000.00 Payment Due to the Agency for Health Care Administration: Notice of Intent -MC &HQ Managed Care Fine Final Order - MC&HQ Medicaid Fine Administrative Complaint -MC&HQ Investigative Cost X__ Other Settlement PAYMENT IS DUE WITHIN 30 DAYS FROM DATE OF FINAL ORDER SEND PAYMENT TO: Agency for Health Care Administration Medicaid Accounts Receivable Attention: Willie Bivens P. O. Box 13749 Tallahassee, FL 32317-3749 Visit ARCA online at 2727 Mahav Drive « Mail Stop #3 wwwijdhe.state fl.us Tallahassee, FL 32308

Docket for Case No: 02-003477MPI