Petitioner: YVONNE RUTHERFORD, M.D.
Respondent: AGENCY FOR HEALTH CARE ADMINISTRATION
Judges: JOHN G. VAN LANINGHAM
Agency: Agency for Health Care Administration
Locations: Tallahassee, Florida
Filed: Dec. 27, 2004
Status: Closed
Settled and/or Dismissed prior to entry of RO/FO on Thursday, April 28, 2005.
Latest Update: Nov. 18, 2024
oA DMIMT STRATTON. on psesiense
STATE OF FLORIDA
AGENCY FOR HEATH CARE ADMINISTRATION
YVONNE RUTHERFORD, M.D.,
Petitioner,
AGENCY FOR HEALTH CARE
me SE
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
wpm
terms of the “settlement agreement”. Based on the
im (Meu
foregoing, this proceeding is CLOSED.
a
py)
DONE and ORDERED on this the /“@—_ day of
Fea a aa , 2009 in Tallahassee, Florida.
Afan Levine, 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 furndshe d-80t--—--es
Vanessa A. Reynolds, Esq.
Conrad & Scherer
Post Office Box 14723
Fort Lauderdale, Florida 33302
Debora Fridie, Esquire
Attorney for Agency
AGENCY FOR HEALTH CARE
" ADMINISTRATION , ;
2727 Mahan Drive ©
Fort Knox Building 3, Mail Stop 3
Tallahassee, Florida 32308 ’ '
Finance and Accounting
John G. Van Laningham
Administrative Law Judge
Division of Administrative
Hearings
The DeSoto Building
1230 Apalachee Parkway
Tallahassee, Florida 32399-3060
Medicaid Program Integrity
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 (Dene-> _,
200%%
tl
ws Richard Shoop, Esquire
Agency~Clerk
State of Florida
Agency for Health Care
mo Administration
2727 Mahan Drive,
Building #3, Mail Stop 3
Tallahassee, Florida 32308-5403
\ STATE OF FLORIDA
DIVISION OF ADMINISTRATIVE HEARINGS
YVONNE RUTHERFORD, M.D.
Petitioner,
vs , . CASE NO. 04-4615MPI
; ‘ 95-0132-008
95-0132-009
AGENCY FOR HEALTH. CARE
ADMINISTRATION,
Respondent. ,
/
STIPULATION AND AGREEMENT
Respondent, Agency for Health Care Administration
(a/k/a “AHCA” or “Agency”), and Petitioner, Yvonne .
Rutherford, M.D. (a/k/a “Petitioner” or “Provider”), by and
through their respective counsel, hereby stipulate and
agree as follows:
1. The two parties enter into this agreement for the
purpose of memorializing the resolution to this matter.
2. PROVIDER is a Medicaid provider in the State of
Florida, operating under provider numbers 0406848 02 and
0406848 03.
3, In its Final Agency Audit Reports, C.I. No.
95-0132-008, dated October 7, 2004, and C.1. No. 95-0132-
009, dated October 15, 2004, (the “FAARs” or “Audit
Letters) AHCA notified PROVIDER that review of Medicaid
Page 1 of 7
Case No. 04-4615MPI
yvonne Rutherford, M.D., vs. AHCA
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
tepayment of an overpayment in the amount of $191,372.07
Mn '
for the October 7, 2004 FAAR, C.I. No. 95-132-008 and
560, 849.60 for the October 15, 2004, FAAR, C.I. No. 95-
0132+009. In response, PROVIDER petitioned for a formal
administrative hearing with the Division of Administrative
Hearings, Case No. 04-4615MPI.
4. There is a rule challenge case related to the
issues in this cause, namely a challenge to the current
Rule 59G-4.230, Florida Administrative Code, namely
Wolfsdorf and Raszynski, M.D., Alberto Marante, M.D., and
( W veh ye nae
Anwar M. Vardag, M.D., vs. AHCA, DOAH Case No. 05-0092RxX.
The Rule incorporates by reference the Florida Medicaid
Physician Services, Coverage, and Limitations Handbook
(a/k/a “Physician Services Handbook” or “Handbook.”).
5. The rule challenge in Wolfsdorf, et. al., VS.
AHCA, DOAH Case No. 05-0092RX, challenged the validity of
the critical care rule contained in the Physician Services
Handbook that was in effect during the audit period in this
case (January i, 1997, through April 30, 2000) and that was
applied to determine the overpayment alleged in the FAAR
issued
Page 2 of 7
ay
Case No. 04-4615MPI ;
Yvonne Rutherford, M.D., vs. AHCA
6. The Agency has recently engaged in new rulemaking
that amends Rule 59G-4.230, F.A.C., the, accompanying
Physician Services Handbook including the critical care
rule, so that the Handbook is in compliance with federal
Medicaid standards. The Rule Challenge Petition has been
voluntarily dismissed with prejudice.
7. Under ‘the revised critical care rule, there would
have been no Medicaid. overpayment alleged against the
Petitioner based upon the then-existing critical care rule
in either the October 7, 2004 FAAR, c.1. No. 95-132-008, or
the October 15, 2004, FAAR,, C.I. No. 95-0132-009.
8. By virtue of this Stipulation and Agreement, the
Agency rescinds both the October 7, 2004 FAAR, C.I. No. 95-
132-008, and the October 15, 2004, FAAR, C.1. No. 95-0132-
009, and agrees that it will not re-issue a FAAR alleging
any overpayment for the January 1, 1997, through April 30,
2000 audit period.
9. Each of the parties will bear responsibility for
the payments of its respective attorneys fees and costs
associated with the above-referenced captioned cause.
10. Because both the October 7, 2004 FAAR, C.1I. No.
95-132-008, and the October 15, 2004, FAAR, C.I. No. 95-
0132-009 that form the basis for Petitioner’s Request for a
Formal Administrative Hearing are rescinded by virtue of
Page 3 of 7
Case No. 04-4615MPI
Yvonne Rutherford, M.D., vs. AHCA
this Stipulation and Agreement, there will remain no issue
in contention between the parties for determination in
either a formal or informal administrative hearing.
‘ 11. The signatories to this Agreement, acting ina
tH t
representative capacity, represent that they are duly
authorized to enter into this Agreement on behalf of the
respective parties.
12. 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.
13. This Agreement constitutes the entire. agreement
etsy
between PROVIDER and the AHCA, including anyone acting for,
(
La
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.
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
Page 4 of 7
my
Case No. 04-4615MPI
Yvonne Rutherford, M.D., vs. AHCA
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 the
‘Agency should issue a Final Order which is consistent with
the terms'of this. Stipulation and Agreement that adopts
this agreement and closes this matter.
15. Provider does hereby discharge the State of
Florida, Agency for Health Care Administration, and its
agents, representatives, and attorneys of and from all
claims, demands, actions, causes: of action, suits, damages,
losses and expenses, of any and every nature whatsoever,
arising out of or in any way related to this matter, cI.
No. 95-132-008, and C.I. No. 95-0132-009,and AHCA’s actions
herein, including, but not limited to, any claims that were
or may be asserted in any federal or state court or
administrative forum, including any claims arising out of
this agreement, by or on behalf of Provider.
16. This Stipulation and 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.
17. To the extent that any provision of this
Stipulation and Agreement is prohibited by law, for any
reason, such provision shall be effective to the extent not
Page 5 of 7
Case No. 04-4615MPI
Yvonne Rutherford, M.D., vs. AHCA
so prohibited, and such prohibition shall not affect any
other provision of this Stipulation and Agreement.
18. This Stipulation and Agreement shall inure to the
benefit of and be binding on each party’s successors,
" '
assigns, heirs, administrators, representatives and
trustees.
“19. This Stipulation and Agreement shall be in full
force and effect upon execution by the respective parties
{
owe
in counterpart.
PETITIONER
YVONNE RUTHERFORD, M.D.
Mery
‘| ALLAN M. GREISSMAN, M.D.
Date: Ly lor , 2005
CONRAD & SCHERER, L.L.P.
BY: Nonna
VANESSA A. REYNOJ@S, ESQUIRE
Date: Octo b4- CO , 2005
Page 6 of 7
By
Case No. 04-4615MPI
Yvonne Rutherford, M.D., vs. AHCA
AGENCY FOR HEALTH CARE
ADMINISTRATION
2727 Mahan Drive, Mail Stop #3
Tallahassee, FL 32308-5403
BY:
Date:
CHRISTA CALAMAS
General Counsel
Date: Occencbev 7
1, 2005
Uta Orde
DEBORA E. FRIDIE
Assistant General Counsel
Date: Noven hor /
, 2005
Page 7 of 7
Docket for Case No: 04-004615MPI
Issue Date |
Proceedings |
Jan. 11, 2006 |
Final Order filed.
|
Apr. 28, 2005 |
Order Closing File. CASE CLOSED.
|
Apr. 21, 2005 |
Amended Response of Respondent Agency to Petitioner`s Motion for Continuance filed.
|
Apr. 21, 2005 |
Response of Respondent Agency to Petitioner`s Motion for Continuance filed.
|
Apr. 15, 2005 |
Petitioner`s Motion for Continuance filed.
|
Apr. 07, 2005 |
Petitioner`s Notice of Serving of Unverified Answers to Amended First Interrogatories and Amended First Expert Interrogatories filed.
|
Apr. 04, 2005 |
Respondent`s Notice of Continuing Compliance with Initial Order Dated December 28, 2004 filed.
|
Mar. 31, 2005 |
Respondent`s Notice of Service of Answers to Petitioners First Interrogatories and Expert Interrogatories filed.
|
Mar. 17, 2005 |
Notice of Unavailability of Counsel for the Respondent Agency filed.
|
Jan. 28, 2005 |
Petitioner`s First Request for Production of Documents filed.
|
Jan. 28, 2005 |
Petitioner`s Notice of Service of First Interrogatories and Expert Interrogatories filed.
|
Jan. 24, 2005 |
Respondent`s Amended First Request for Production of Documents to Petitioner filed.
|
Jan. 24, 2005 |
Respondent`s Notice of Service of Amended First Interrogatories and Amended First Expert Interrogatories filed.
|
Jan. 14, 2005 |
Respondent`s Amended Notice of Service of First Interrogatories and First Expert Interrogatories filed.
|
Jan. 13, 2005 |
Order of Pre-hearing Instructions.
|
Jan. 13, 2005 |
Notice of Hearing (hearing set for May 11-13, 2005; 9:00am; Tallahasse).
|
Jan. 13, 2005 |
Respondent`s First Request for Production of Documents to Petitioner filed.
|
Jan. 13, 2005 |
Respondent`s Notice of Service of First Interrogatories and First Expert Interrogatories filed.
|
Jan. 11, 2005 |
Joint Response to Initial Order, Including Joint Request for Formal Hearing to be Set More than 90 Days from Date of Assignment of Judge Pursuant to S.409.913(30), Fla. Stat. filed.
|
Jan. 04, 2005 |
Order Enlarging Time (response to Initial Order due January 11, 2005)
|
Dec. 28, 2004 |
Initial Order.
|
Dec. 27, 2004 |
Respondent`s Motion for Enlargement of Time to file Joint Response to Initial Order (via efiling)
|
Dec. 27, 2004 |
Notice (of Agency referral) filed.
|
Dec. 27, 2004 |
Petition for Formal Administrative Hearing filed.
|
Dec. 27, 2004 |
Final Agency Audit Report filed.
|