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PLANTATION GENERAL HOSPITAL, L.P., D/B/A PLANTATION GENERAL HOSPITAL vs AGENCY FOR HEALTH CARE ADMINISTRATION, 02-003926MPI (2002)

Court: Division of Administrative Hearings, Florida Number: 02-003926MPI Visitors: 5
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: Jun. 01, 2024
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).
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.
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).
Apr. 18, 2002 Final Agency Audit Report filed.
Apr. 18, 2002 Petition for Formal Administrative Hearing filed.
Apr. 18, 2002 Notice (of Agency referral) filed.
Source:  Florida - Division of Administrative Hearings

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