Petitioner: PLANTATION GENERAL HOSPITAL, L.P., D/B/A PLANTATION GENERAL HOSPITAL
Respondent: AGENCY FOR HEALTH CARE ADMINISTRATION
Judges: STUART M. LERNER
Agency: Agency for Health Care Administration
Locations: Tallahassee, Florida
Filed: Oct. 02, 2002
Status: Closed
Settled and/or Dismissed prior to entry of RO/FO on Tuesday, December 10, 2002.
Latest Update: Jan. 20, 2025
STATE OF FLORIDA 44
AGENCY FOR HEALTH CARE ADMINISTRATION :
PLANTATION GENERAL HOSPITAL, L.P., 4
d/b/a PLANTATION GENERAL HOSPITAL,
Petitioner, S ta Lo. Y net
ys. DOAH CASE NO. 02-3926MPI 3
AUDIT NO. C.L. 01-1938-000
co cane
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. Five Thousand Dollars of the agreed
upon amount is for reimbursement of investigative costs. Based on the foregoing, this
file is CLOSED.
DONE AND ORDERED on this the 22 /_ day of Tantoary , 2003,
in Tallahassee, Florida.
Jt.
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:
Richard Ellis, Esquire
Rutledge, Ecenis, Purnell & Hoffman
215 South Monroe Street, Suite 420
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)
Judy Hefren, Acting Bureau Chief
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)
Debbie Lynn, Analyst
Medicaid Program Integrity
(Interoffice)
Stuart M. Lerner
Administrative Law Judge
Division of Administrative Hearings
(Interoffice)
CERTIFICATE OF SERVICE
1 HEREBY CERTIFY that a true and correct copy of the foregoing has been
ar
furnished to the above named addresses by U.S. Mail on this the a vi day of
Uanua Cc |, 2003.
' (
; . ; (
. Charla eo POM PoC
-©*Lealand 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
DIVISION OF ADMINISTRATIVE HEARINGS
PLANTATION GENERAL HOSPITAL, L.P.,
d/bia PLANTATION GENERAL HOSPITAL,
Petitioner,
vs. CASE NO. 02-3926MPI
STATE OF FLORIDA, AGENCY FOR
HEALTH CARE ADMINISTRATION,
Respondent.
/
SETTLEMENT AGREEMENT
STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION
(“AHCA” or “the Agency”), and PLANTATION GENERAL HOSPITAL, L.P., D/B/A
PLANTATION GENERAL HOSPITAL, (“PROVIDER”), by and _ through the
undersigned, hereby stipulate and agree as follows:
1. This 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 was a Medicaid provider in the State of Florida during the
period covered in the subject audit.
3. In its final agency audit report dated March 7, 2002, AHCA notified
PROVIDER that a review of Medicaid claims performed by Medicaid Program Integrity
(MPI) indicated that, in its opinion, some claims in whole or in part were not
reimbursable by Medicaid. The Agency sought recovery of the overpayment in the
amount of $131,234.20. In response to the audit letter dated March 7, 2002,
PROVIDER filed a petition for a formal administrative hearing, which was assigned
DOAH Case No. 02-3926MPI. Subsequently and after additional information was
furnished by the provider, AHCA again reviewed the disputed claims and determined
the outstanding amount of overpayment should be adjusted.
4. In order to resolve this matter without further administrative proceedings,
PROVIDER and the AHCA expressly agree as follows:
(1)
(2)
(3)
AHCA agrees to accept the payment set forth herein in settlement
of the overpayment issues arising from the MPI review.
Within thirty days of receipt of the final order, PROVIDER agrees to
make a single payment of Thirty-Six Thousand Six Hundred Six
Dollars and Eight cents ($36,606.08). That payment, combined
with PROVIDER’s previous payment of $50,620.42 for the subject
audit, equals Eighty Seven Thousand Two Hundred Twenty-Six
Dollars and Fifty Cents ($87,226.50) in full and complete settlement
of all claims including costs and fees in the subject proceedings
before the Division of Administrative Hearings (specifically and only
DOAH Case No. 02-3926MPI; audit no. C.I. 01-1938-000).
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.1. 01-1938-
000.
(4) PROVIDER agrees to refrain from billing the Medicaid Program in
any manner for any and all claims that were denied as a result 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. Except as set forth herein, 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 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 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 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.
PLANTATION GENERAL HOSPITAL, L.P.
D/B/A PLANTATION GENERAL HOSPITAL
Dated: JES AS , 2002
BY: LAO LF LE fib gS
(Print name)
is: ek. Fit Nanya Of rox
Lan. Zo A C Dated: 1p fez , 2002
Rick Ellis, Esquire
Attorney for Petitioner
FLORIDA AGENCY FOR HEALTH CARE
ADMINISTRATION
2727 Mahan Drive, Mail Stop #3
Tallahassee, FL 32308-5403
LZ, he aa Dated:
Valda Christian
General Counsel
Grant P. Dearborn
Assistant General Counsel
phber Dated:
Rufus Noble
Inspector General
, 2003
, 2003
, 2003
Docket for Case No: 02-003926MPI
Issue Date |
Proceedings |
Jan. 30, 2003 |
Final Order filed.
|
Dec. 10, 2002 |
Order Closing File issued. CASE CLOSED.
|
Dec. 09, 2002 |
Notice of Cancellation of Deposition of Joseph Sachs, M.D. filed.
|
Dec. 09, 2002 |
Notice of Cancellation of Deposition of Gerald Lavandosky, M.D.filed.
|
Dec. 09, 2002 |
Notice of Cancellation of Deposition of Nedra Mansager filed.
|
Dec. 09, 2002 |
Joint Motion to Cancel Hearing and Relinquish Jurisdiction (filed by Respondent via facsimile).
|
Dec. 06, 2002 |
Notice of Cancellation of Motion Hearing (filed by S. Ecenia via facsimile).
|
Dec. 04, 2002 |
Agency for Health Care Administration`s Response to Motion for Summary Order (filed via facsimile).
|
Dec. 04, 2002 |
Notice of Motion Hearing (filed by Petitioner via facsimile).
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Dec. 03, 2002 |
Notice of Taking Non-Party Deposition Duces Tecum (J. Sachs, M.D.) filed via facsimile.
|
Dec. 03, 2002 |
Notice of Taking Deposition Duces Tecum (N. Mansager, R.N.) filed via facsimile.
|
Dec. 03, 2002 |
Order Denying Motion to Seal Court File issued.
|
Dec. 02, 2002 |
Response to Order Requiring Specificity (filed by Respondent via facsimile).
|
Dec. 02, 2002 |
Request to Set Hearing at Later Date (filed by Respondent via facsimile).
|
Nov. 27, 2002 |
Notice of Taking Deposition Duces Tecum (G. Lavandosky, M.D.) filed via facsimile.
|
Nov. 27, 2002 |
Amended Notice of Taking Non-Party Deposition Duces Tecum (T. Lowe, M.D.) filed via facsimile.
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Nov. 26, 2002 |
Petitioner`s Motion for Summary Recommended Order filed.
|
Nov. 26, 2002 |
Notice of Deposition (B. Fair) filed via facsimile.
|
Nov. 21, 2002 |
Order Requiring Greater Specificity issued. (no later than December 2, 2002, Respondent shall file a written advisement)
|
Nov. 20, 2002 |
Motion to Seal Court File (filed by Respondent via facsimile).
|
Nov. 19, 2002 |
Notice of Taking Deposition Duces Tecum (D. Lynn, T. Lowe, M.D. and J. MacDonald, M.D.) filed via facsimile.
|
Nov. 15, 2002 |
Petition for Investigative, Legal and Expert Witness Costs (filed by Respondent via facsimile).
|
Nov. 14, 2002 |
Notice of Taking Deposition Duces Tecum (J. MacDonald, M.D.) filed.
|
Oct. 16, 2002 |
Order of Pre-hearing Instructions issued.
|
Oct. 16, 2002 |
Notice of Hearing issued (hearing set for December 19 and 20, 2002; 9:00 a.m.; Tallahassee, FL).
|
Oct. 15, 2002 |
Joint Response to Order Reopening File (filed by Respondent via facsimile).
|
Oct. 10, 2002 |
Order Reopening File issued.
|
Oct. 09, 2002 |
Plantation General Hospital`s Response to Respondent`s Request for Admissions filed.
|
Oct. 04, 2002 |
Notice of Service of Plantation General Hospital`s Answers and Objections to Respondent`s First Set of Interrogatories to Petitioner filed.
|
Oct. 04, 2002 |
Plantation General Hospital`s Response to Respondent`s Request for Production of Documents filed.
|
Oct. 03, 2002 |
Plantation General Hospital`s First Request for Production of Documents to the Agency for Health Care Administration filed. |
Oct. 03, 2002 |
Notice of Service of Plantation General Hospital`s First Set of Interrogatories to Agency for Health Care Administration filed. |
Oct. 02, 2002 |
Motion to Reopen Case (Previously Filed Under DOAH Case No. 02-1592MPI filed via facsimile).
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Apr. 18, 2002 |
Final Agency Audit Report filed.
|
Apr. 18, 2002 |
Petition for Formal Administrative Hearing filed.
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Apr. 18, 2002 |
Notice (of Agency referral) filed.
|