fi ray 2% vey ~ A a: So STATE OF FLORIDA DIVISION OF ADMINISTRATIVE HEARINGS , -Ct0S Qa es RICHARD DOUYON, M.D., mmp—-C “Ay “e CASE NO. 04-0395 MPI oN aS Petitioner, AHCA NO. C. I. 01-0558-000 a FY RENDITION NO.: AHCA-04- near Vs. ne = 4 STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, Respondent. / FINAL ORDER This cause was referred to the Division of Administrative Hearings and assigned to an Administrative Law Judge (ALJ) for a formal administrative hearing and the entry of a Recommended Order. The matter was remanded back to the Agency on June 15, 2004 and the parties have come to an amicable resolution and have executed a Settlement Agreement reflecting such. RULING ON EXCEPTIONS No exceptions were filed. FINDINGS OF FACT The Agency adopts the findings of fact set forth in the Settlement Agreement. CONCLUSIONS OF LAW The Agency adopts the conclusions of law set forth in the Settlement Agreement.. IT IS THEREFORE ADJUDGED THAT: The Petitioner was overpaid $19,596.53 in Medicaid payments during the period extending from May 22, 1998 through May 22, 2000. Petitioner shall make full payment of this amount plus $2,275.00 costs of prosecution and statutory interest within 30 days of the rendition of this Final Order. Petitioner shall pay by check payable to the Agency for Health Care Administration and mailed to the Agency for Health Care Administration, Office of Finance and Accounting, 2727 Mahan Drive, Fort Knox Building 2, Mail Stop 14, Tallahassee, Florida 32308. DONE and ORDERED in DOAH Case No. 04-0395 MPI this af! day of _ 4 epopcsge_ , 2004, in Tallahassee, Florida. STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION ~ EK LEVINE, SECRETARY NOTICE OF RIGHT TO JUDICIAL REVIEW A PARTY WHO IS ADVERSELY AFFECTED BY THIS FINAL ORDER IS ENTITLED TO JUDICIAL REVIEW, WHICH SHALL BE INSTITUTED BY FILING THE ORIGINAL NOTICE OF APPEAL WITH THE AGENCY CLERK OF AHCA, AND A COPY ALONG WITH THE FILING FEE 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 THE RENDITION OF THE ORDER TO BE REVIEWED. CERTIFICATE OF SERVICE | HEREBY CERTIFY that a true and correct copy of the foregoing Final Order has been furnished by U.S. or interoffice mail to the persons named below on this _ qo day oe ecnaligos ~ f } la UV, - ft State of Florida, tency for | Health Care Administration 2727 Mahan Drive, MS 3 Tallahassee, Florida 32308 (850) 922-5873 COPIES FURNISHED TO: Michael M. Parrish Administrative Law Judge Division of Administrative Hearing 1230 Apalachee Parkway The DeSoto Building Tallahassee, Florida 32399-3060 Jeffries H. Duvall, Esquire State of Florida, Agency for Health Care Administration 2727 Mahan Drive, MS 3 Tallahassee, Florida 32308 Dr. Richard Douyon c/o Louise Jeroslow 6075 Sunset Drive, Suite 201 Miami, FL 33143 Timothy Byrnes Medicaid Program Integrity Jean Lombardi Medicaid Finance and Accounting 2727 Mahan Drive, MS 14 Tallahassee, Florida 32308 STATE OF FLORIDA DIVISION OF ADMINISTRATIVE HEARINGS RICHARD DOUYON, M.D., Petitioner, vs. CASE NO. 04-0395MPI STATE OF FLORIDA, AGENCY FOR JUDGE: Michael M. Parrish HEALTH CARE ADMINISTRATION, Respondent. _ / SETTLEMENT AGREEMENT STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION (“AHCA” or “the Agency”), and RICHARD DOUYON, M.D.., (“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 is a Medicaid provider in the State of Florida. 3. In its final agency audit report dated November 21, 2003, 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 $24,851.09. In response to the audit letter dated November 21, 2003, PROVIDER filed a petition for a formal administrative hearing, which was assigned DOAH Case No. 04-0395. Based upon information subsequently provided AHCA by the Petitioner, a corrected overpayment was determined. The parties have agreed that the amount of $19,596.53, plus $2,275.00 costs, paid withi n 30 days of the finalization of this settlement agreement, will be acceptable by the Agency as full payment of audit number C.I. 01-0558-000. 4. In order to resolve this matter without further administrative proceedings, PROVIDER and the AHCA expressly agree as follows: (A) (B) (C) @) 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 Nineteen Thousand Five Hundred Ninety- Six Dollars and Fifty-Three cents plus Two Thousand Seventy-Five dollars costs, in full and complete settlement of all claims in the proceedings before the Division of Administrative Hearings (DOAH Case No. 04-0395 MPI). 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. 01-0558- 000. 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. Payment shall be made to: AGENCY FOR HEALTHCARE ADMINISTRATION Medicaid Accounts Receivable Post Office Box 13749 Tallahassee, Florida 32317-3749 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 porty 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. 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. 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. 15. To the extent that any provision of this Agreement is prehibited 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. 16. | This Agreement shall inure to the benefit of and be binding on each party’s successors, assigns, heirs, administrators, representatives and trustees. 17. All times stated herein are of the essence of this Agreement. 18. This Agreement shall be in full force and effect upon execution by the respective parties in counterpart. Dated: 3 bo Of 2004 RICHARD DO N, M.D. Z pd lad uate) Dated: §/23/dY 2004 oulse I. Jereslow, Esquire Attorney for Petitioner FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION 2727 Mahan Drive, Mail Stop #3 Tallahassee, FL 32308-5403 flee hh Valda Christian wnt Dated: La LE (2004 General Counsel eke doce Dated: [of fort , 2004 Dated: s Le [- 2004 GF _fossbl Dated: (27 Z6 «is 2004 Jasies Boyd Inspector General Mea Je iy SAB Khant G eneral Counsel

Docket for Case No: 04-000395MPI